Drug pricing reform has become a major focus of Medicaid cost-containment efforts. Policymakers continue exploring supplemental rebate programs, alternative purchasing models, and initiatives such as CMS's GENEROUS Model in an effort to reduce prescription drug spending and improve purchasing efficiency. These strategies may help lower healthcare...
Stephen Konsin Jr. from Syrtis Solutions, a solution provider at the Marcus Evans Value-Based Care Summit 2026, discusses the growing need for proactive Medicaid payment accuracy and cost avoidance strategies. Interview with: Stephen Konsin Jr., Vice President of Sales, Syrtis Solutions “The window for demonstrating proactive prevention...
As states begin outlining fiscal year (FY) 2027 Medicaid budgets, many programs are confronting a tighter and less predictable financial environment. State revenue growth has cooled, healthcare costs remain elevated, and federal policy changes enacted through the 2025 budget reconciliation law have reshaped how funding...
Medicaid COB is no longer a back-office process—it’s a strategic necessity for states confronting record fiscal pressure. With billions in federal reductions on the horizon, states are being forced to rethink how they manage their Medicaid programs. The Medicare Rights Center has reported that states...
Medicaid, the largest public health insurance program in the United States, is under scrutiny, not for its mission, but for its costs. What started as a vital safety net has grown into a massive budget line item for nearly every state. With Medicaid now accounting...
With the latest House budget proposal threatening to cut billions from Medicaid, state programs and Managed Care Organizations (MCOs) face an urgent challenge. To sustain healthcare services and maximize every dollar, Medicaid agencies must take immediate action to reduce financial waste. One of the most...
Syrtis Solutions, a leading provider of real-time Other Health Insurance (OHI) coverage information for payers of last resort, recently accomplished a notable milestone by being designated a preferred vendor for the Association for Community Affiliated Plans (ACAP). This achievement is a reflection of Syrtis Solutions'...
Medicaid has become an essential safety net program that delivers access to health care for millions of Americans. Payment for this health care is either delegated to Medicaid or other third party insurance coverage. In 2012, 7.6 million people on Medicaid had other private health...