The pandemic has not been good for children or their physicians. Well-child and other non-emergency visits are down, so children are missing important screening benchmarks as well as immunizations.  Pediatric practitioners who are paid on a fee-for-service basis have seen their revenues fall and the financial stability of their practices imperiled. The situation has improved […]

On the way out the door, CMS Administrator Seema Verma issued changes to Medicaid managed care regulations that, among other things, weaken the standards for measuring the adequacy of managed care organization (MCO) provider networks. These changes, which will be effective December 14, were adopted over the objections of CCF and other beneficiary advocates. They […]

In most states, the responsibility for ensuring that children enrolled in Medicaid receive needed services rests with managed care organizations (MCOs).  They are stewards for millions of children and billions of Medicaid funding intended to meet children’s health care needs.  Yet there is little transparency about how individual MCOs are performing for children.  The logical […]

Q3 2020 closed on September 30, and publicly held companies have reported their financial performance. These reports, known as Form 10-Qs, are designed to provide investors with some transparency about the companies in which they are investing. Here’s what they tell us about how the five companies with the largest Medicaid managed care enrollments have […]

2020 Q2 marked the arrival of the coronavirus pandemic, stay-at-home orders, school closures, social distancing, and a recession.  Families put off going to the doctor’s office for routine, non-emergency care.  Primary care physician practices and clinics that bill for each visit saw sharp drops in their revenues as patients stayed at home (pediatricians’ offices were […]