Joseph Burns

September 22, 2022

North Carolina pioneered patient-centered medical homes and other ways of managing the healthcare of Medicaid beneficiaries. But it was one of the last states to contract with managed care organizations and hasn’t expanded Medicaid.

July 22, 2022

The program started before specialty drugs became such a large expense for Medicare and its beneficiaries. Congress is considering legislation that would cap beneficiary out-of-pocket costs and require price discounts from manufacturers.

June 20, 2022

As many asme 14 million people with Medicaid coverage stand to lose their health insurance when the COVID-19 public health emergency ends.

June 20, 2022

States looked to Medicaid managed care plans to control costs and provide some predictability. Now a growing number are asking questions of the plans and investigating whether the plans are living up to their state contracts. Meanwhile, new federal reporting requirements are being implemented that may shed some light on how the plans operate.

May 11, 2022

Price-transparency rule allows insurers to cut MLR payments by using incentives to encourage consumers to choose low-cost, high-value providers.

April 14, 2022

Although health systems say they deliver better health outcomes and lower costs, research on how physicians are compensated suggest otherwise.