Many states are enacting restrictions on insurers’ prior authorization policies, but these laws may increase costs and lead to other undesirable consequences.

Managed Care Reflections: A Q&A With Dora Hughes, MD, MPH

By Dora Hughes, MD, MPH
Christina Mattina

September 4th 2025

To mark the 30th anniversary of The American Journal of Managed Care, each issue in 2025 includes a special feature: reflections from a thought leader on what has changed—and what has not—over the past 3 decades and what’s next for managed care. The September issue features a conversation with Dora Hughes, MD, MPH, chief medical officer and director of the Center for Clinical Standards and Quality at CMS.

CDC | Image credit: Tada Images - stock.adobe.com

West Coast States Form Alliance to Provide Public Health Recommendations

By Pearl Steinzor

September 3rd 2025

The governors of Washington, California, and Oregon have launched the West Coast Health Alliance to provide evidence-based guidance amid shifting CDC policies.

Contributor: Why US Health Care Is Ripe for Change

By Ariela Simerman

September 2nd 2025

Why is health care so staggeringly difficult to use? How do we fix it? To move forward, we first must look back, because the system we have today was not really designed, it evolved, notes Ariela Simerman, Turquoise Health.

america states with medicaid expansion uncertainty | Image credit: Matthieu - stock.adobe.com

Medicaid Expansion's Unfinished Map: Some Southern States Still at a Crossroads

By Skylar Jeremias

August 29th 2025

Medicaid expansion significantly improves health coverage and access, yet several Southern states face a persistent coverage gap amid political challenges.

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