Description: What you need to know about risk scores to be competitive in the Medicare Advantage market.

Description: Analysis of data from three Medicaid managed care plans examines enrollment and cost trends for newly eligible enrollees under the ACA's Medicaid expansion.

Description: A proposal to reform current health care market, from a 'preferred payer' system, in which Medicare and Medicaid pay less than the true cost while others must then pay more, to a 'value for money' system. This would be achieved by requiring providers to bill all patients the same rate for the same services, with a standard bundling format to make all providers' rate differences transparent. Differences between billed charges and what Medicare pays would be made up by the Medicare patient, rather than subsidized by those outside of Medicare.

Description: A summary of the driving forces behind, and effects of, the historical increases and future expectations of Generic Dispensing Rates.

Description: Changes in CMS requirements for 2011 Medicare Part D plans aimed at reducing confusion surrounding the PDP selection process by making plan differences more visible to seniors. Carriers have responded by making the most significant changes in plan offerings since the program's inception, which is expected to result in membership shifts.

Description: The editors of Health Watch have made health care reform the focus of the Sepctember 2009 issue, and provide an introduction to the issue's contents.

Description: This article makes organizations entering the MA market aware of the star rating climate, as well as short- and long-term star rating & revenue considerations.