managed care

The CMS predicts that the fastest-growing categories for all of Medicare in 2026 are managed care, which means Medicare Advantage, and outpatient hospital services.

There are a range of factors that can influence spending for Medicare in any given year, like expensive new drugs for diseases affecting millions of people or higher costs of managed care as more people choose Medicare Advantage.

Insurance coverage is limited for weight loss drugs, and the companies see in the direct-to-consumer market a way to get around the limits imposed by managed care.

It additionally limits state funding mechanisms, such as taxes paid by managed care providers, and establishes federal penalties for improper payments.

The managed care company had called for earnings of “no less than $19” in July, down from $22 at the midpoint of the previous range and marking the second guidance cut in weeks.