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Could Managed Care Offset OK's Surge in Medicaid Spending for Emergency Room Visits?
Medicaid-financed emergency room costs statewide grew nearly $10 million to $178.3 million in fiscal year 2013.
Medicaid-financed emergency room costs statewide grew nearly $10 million to $178.3 million in fiscal year 2013.
The increase, from $169.6 million in 2012, came as SoonerCare, the state Medicaid system, expanded to cover for the first time ever more than a quarter of the state’s 3.8 million people.
Emergency room spending rose sharply in spite of a state Health Care Authority effort begun in late 2011 to curb costs by contacting and counseling frequent ER users.
“After-the-fact” intervention programs, like Oklahoma’s, have marginal or no utility, said Jonathan Small, fiscal analyst at the Oklahoma Council of Public Affairs.
Read the full story here: http://bit.ly/1ntJS7h
Source: Oklahoma
AI Meets Medicare: Inside CMS’s WISeR Model With Sanjay Doddamani, MD, MBA, Part 2
August 5th 2025In this second part of his interview with The American Journal of Managed Care®, Sanjay Doddamani, MD, MBA, a former senior advisor to CMMI and founder and CEO of Guidehealth, continues a dialogue on the future of value-based care and the promise—and limits—of AI-enabled innovation, reflecting on challenges like rising Medicare costs and patients’ growing financial burdens.
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Trump Directs Pharma Companies on Cutting Drug Prices Under Most-Favored-Nation Order
July 31st 2025President Donald Trump has sent letters to pharmaceutical companies, aiming to compel them to lower drug prices in the US to match the lowest prices offered in other developed nations, a move that could significantly reduce costs and disrupt the current system of pharmacy benefit managers.
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