Auditors say the increase coincided with an overall increase in Medicaid enrollment during the first year of the pandemic. The value of improper Medicaid capitation payments made by states to managed ...

Findings from F.X. Andoh-Adjei and Colleagues Update Understanding of Health Insurance (Does capitation payment under national health insurance affect subscribers' trust in their primary care provider ...

* The State Agency Made Unallowable Payments to Certain Medicaid Managed Care Entities ... 5 - Unallowable Prepaid Inpatient Health Plan Payments ... 5 - Unallowable Prepaid Ambulatory Health Plan ...

The California Department of Health Care Services agrees with the audit findings. Federal watchdogs are asking Medi-Cal to refund $15.7 million in unallowable capitation payments made to managed care ...

BOSTON, Mass. (SHNS)–MassHealth errantly paid more than $84 million related to care for residents who were living in other states, Auditor Diana DiZoglio’s office concluded in a new report that the ...

Established healthcare organizations, whether it be health systems, accountable care organizations, or independent provider groups often grapple with the dilemma of fully embracing risk. Fears of ...

Jointly authored by administration leaders, a recent New England Journal of Medicine Perspective reflects on the past and lays out a future vision for accountable care organizations (ACOs) that ...

Despite efforts to shift provider payment away from fee-for-service and toward more risk-based alternatives, fee-for-service remains dominant -- and is growing, according to a study published in ...