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:
ACA Network Regulatory Filings Are Inaccurate, Poorly Match Provider Directories
September 16th 2025A secret shopper survey (N = 8306) in Pennsylvania’s Affordable Care Act (ACA) Marketplace found inconsistencies between carrier regulatory filings and provider directories, frequent inaccuracies in regulatory filings, and challenges in securing timely appointments.
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