Latest News On Managed Care

Latest KFF Health News Stories

Industry Groups in California Vie for New Medicaid Money

KFF Health News Original

State officials have promised to boost funding for California’s Medicaid program by $11.1 billion starting next year, with most of that money earmarked for higher payments to doctors, hospitals, and other providers. But the details have yet to be worked out, and powerful health industry groups are jockeying for position.

Health Care Coalition Jockeys Over Medi-Cal Spending, Eyes Ballot Initiative

KFF Health News Original

California Healthline has learned that a coalition of doctors, hospitals, insurers, and community clinics want to lock in a tax on health insurance companies to draw in extra Medicaid funding. It also wants to make the tax permanent.

Montana Hires a Medicaid Director With a Managed-Care Past

KFF Health News Original

Montana, one of about a dozen states still managing its own Medicaid programs, has a new Medicaid director who championed handing the management of the program to private companies in Iowa and Kansas.

Record Fines Might Mean California Is Finally Serious About Improving Medi-Cal

KFF Health News Original

California regulators issued record fines against L.A. Care, the state’s largest Medi-Cal managed-care plan, for providing inadequate care to its enrollees. But whether the penalties are a sign that the state will make a more forceful effort to improve Medi-Cal’s overall quality of care remains to be seen.

Georgia Bill Aims to Limit Profits of Medicaid Managed-Care Companies

KFF Health News Original

Georgia lawmakers unveiled a mental health bill that would limit the profits of the managed-care companies that serve Medicaid patients. KHN previously reported that Georgia, unlike most states, does not set a medical loss ratio for the companies’ spending on medical care and quality improvements.

California’s Reboot of Troubled Medi-Cal Puts Pressure on Health Plans

KFF Health News Original

The nine commercial insurers in Medi-Cal must reapply by submitting bids for new contracts. The state hopes the process will improve care for low-income residents and tighten accountability, something critics say has been missing.

A Switch To Medicaid Managed Care Worries Some Illinois Foster Families

KFF Health News Original

Illinois is moving thousands of children into its Medicaid managed-care program. Proponents say the approach can cut costs while increasing access to care. But after a phase-one rollout of the new health plans caused thousands to temporarily lose coverage, some question whether it’s the right move.

Despite Quick Fixes, Kaiser Permanente Mental Health Care Still Lags

KFF Health News Original

Interviews with dozens of Kaiser Permanente therapists, patients and industry experts reveal superficial changes that look good on paper but do not translate into more effective and accessible care.

California Nursing Home Residents Told To Find New Homes

KFF Health News Original

Dozens of frail nursing home residents have been informed by their Medi-Cal managed care plans that they are no longer eligible for long-term care. Some health care advocates and legal aid attorneys fear that such terminations will increase as the state implements mandatory managed care for nursing home residents.

Coverage Denied: Medicaid Patients Suffer As Layers Of Private Companies Profit

KFF Health News Original

Managed-care plans, which reap billions in taxpayer dollars to coordinate care for low-income Americans on Medicaid, outsource crucial treatment decisions to subcontractors that aren’t directly accountable to the government. In California, health officials say one firm improperly withheld or delayed care for hundreds of people.

Matrimonio gana millones a costa de Medicaid

KFF Health News Original

Norma Díaz y su esposo, Joseph García, han dedicado sus carreras a administrar una aseguradora de salud sin fines de lucro que cubre a residentes carenciados de California. Y en el proceso, han ganado millones de dólares.

Couple Makes Millions Off Medicaid Managed Care As Oversight Lags

KFF Health News Original

How a California health plan’s CEO and her husband, an executive consultant, got rich off the taxpayer-funded program for the poor. Critics see a conflict of interest, the plan doesn’t, and the state has no rules either way.

California Firm Running Physician Practices Is Closing Down as Scrutiny Ramps Up

KFF Health News Original

State regulators and insurers are looking into SynerMed, which medical groups depend upon to handle their finances and business operations. The groups, serving 1 million patients, fear a messy fallout.

Patients, Health Insurers Challenge Iowa’s Privatized Medicaid

KFF Health News Original

Complaints are rising against for-profit insurance companies that manage Medicaid for about 600,000 Iowans. The privatization of Medicaid is a national trend affecting more than half of the 74 million Americans who get their health care through the state-federal program.