Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.
Every week, The American Journal of Managed Care® recaps the top managed care news of the week, and you can now listen to it on our podcast, Managed Care Cast.
This week, the top managed care stories included CMS outlining a plan to encourage Medicare accountable care organizations to take on more risk, faster; a study found substantial growth in Medicaid managed care enrollment; an analysis showed nearly 1 in 5 inpatient hospital stays includes a claim from an out-of-network provider.
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CMS Plans to Overhaul MSSP Program to Force More Risk on ACOs
CMS Proposal Is a Start for Making Risk More Appealing to ACOs
Medicaid Managed Care Grew Substantially From 1999 to 2012
Nearly 1 in 5 Inpatient Admissions Includes a Claim From an Out-of-Network Provider
CVS Will Rely on ICER Data as It Seeks to Curb Costs, Implement "Zero-Dollar Drug List"
What We're Reading: Ark. Work Requirements Lawsuit; CVS' Cost Savings Plan; Kavanaugh and Healthcare
Choosing Wisely Clinical Decision Support Adherence and Associated Inpatient Outcomes
Read more about the stories in this podcast:
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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A meta-analysis showed that control group outcomes in psilocybin trials for depression were significantly weaker than those in selective serotonin reuptake inhibitor (SSRI) and esketamine trials, suggesting that psilocybin’s large observed treatment effects may be inflated by methodological factors such as functional unblinding and expectancy bias.
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Legal Navigation Services Key to Addressing Disparities in Cancer Care
July 31st 2025A significant number of patients with cancer, caregivers, and health care professionals face significant disparities in legal issues, with the most common needs revolving around health insurance, finances, employment, and disability insurance.
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