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Oregon Medicaid CCOs Had Mixed Financial Results & Higher Costs Due To Higher Health Care Utilization
Oregon’s 16 Medicaid Coordinated Care Organizations (CCOs) had mixed financial results during 2024, according to an analysis by the Oregon Health Authority (OHA). Nine of the CCOs operated at a […]
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Employer Health Care Costs Projected To Increase By 9.1% For 2026 Plan Year
U.S. employers project that their health care costs will increase by 9.1% in 2026, which is a higher pace than the previous two years, when increases were 8.1% in 2025 […]
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Nevada Health Link Insurance Marketplace Launches ‘Battle Born’ Public Health Insurance Option
Nevada has become the third state to launch a public health insurance option, after Washington and Colorado, with the rollout of the Battle Born State Plans (BBSPs) administered by three […]
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California To Phase Out Prior Authorization For Health Care Services With Approval Rates Of 90% Or Higher
New legislation in California, signed on October 6, 2025, directs health plans and health insurers to phase out prior authorization for health care services with approval rates of 90% or […]
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Centauri Health Solutions Launches Member Insights To Support Dual-Eligible Medicare Advantage Members
Centauri Health Solutions (Centauri), a Phoenix, Arizona-based health information technology company, announced the launch of Member Insights—a comprehensive, member-centric solution designed to address the financial, social, and clinical needs of […]
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Pear Suite Secures $7.6 Million In Series A Funding To Power Community Health Workers Nationwide
Pear Suite, a digital health company empowering community health workers (CHWs), announced that it has raised $7.6 million in Series A funding to advance the development of its artificial intelligence […]
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Epicured & Fallon Health Announce Partnership To Provide Medically Tailored Meals To Fallon Health PACE Members
Epicured Inc., a “food-is-medicine” organization dedicated to combating and preventing chronic disease, announced a partnership with Fallon Health, which offers the Program of All-Inclusive Care for the Elderly (PACE)—a comprehensive, […]
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Delaware Rolling Out Statewide Behavioral Health Coordination Platform
The Delaware Division of Substance Abuse and Mental Health (DSAMH), in partnership with Bamboo Health, announced the rollout of the Delaware Treatment and Referral Network 360 (DTRN360) behavioral health care […]
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Innovations For Managing Justice-Involved Consumers With Behavioral Health Disorders
This supplemental guidebook is designed to take decision makers from insight to impact, connecting data, policy, and real-world care models that are moving the needle on outcomes and engagement for justice-involved individuals.
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CMS Denies Matching Funds For Managed Care Payments For Emergency Medicaid Coverage For Immigrants Ineligible For Full Benefits
The Centers for Medicare & Medicaid Services (CMS) issued guidance explaining its updated interpretation of when states can claim federal financial participation (FFP), or matching funds, for emergency Medicaid-covered services […]