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Growing Pains for Medicaid Managed Care Expansions
Although they're not expanding Medicaid under the Affordable Care Act, Texas, Florida and other states are expanding managed care, bringing insurers opportunities as well as challenges, including competition from provider-based health plans.
Although they're not expanding Medicaid under the Affordable Care Act, Texas, Florida and other states are expanding managed care, bringing insurers opportunities as well as challenges, including competition from provider-based health plans.
In Texas, the unduplicated enrollment numbers in Medicaid managed care programs total approximately 2.84 million residents, and Superior HealthPlan, a subsidiary of Centene, and Amerigroup, a subsidiary of WellPoint, have received the bulk of managed care organization contracts over the past few years.
The Texas Health and Human Services Commission's managed care contracts include requirements that organizations have sufficient capacity to serve the expected enrollment, meet service area needs with geographic distribution of preventative, primary care, and specialty service providers, and report how often members go out of network.
Read the full story here: http://bit.ly/1myLSad
Source: Healthcare Payer News
Neurologists Share Tips for Securing Patient Access to Gene Therapies
March 19th 2025Tenacious efforts at every level, from the individual clinician to the hospital to the state to Congress, will be needed to make sure patients can access life-saving gene therapies for neuromuscular diseases.
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Bustling Gene Therapy Pipeline for Neuromuscular Diseases Brings Thorny Questions to the Clinic
March 18th 2025The rapid development of gene therapy options for treating neuromuscular diseases has created new therapeutic options but also logistical hurdles and a need for complex discussions between clinicians and families.
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