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The new Medicaid managed-care contracts, which will be awarded in five zones in January, will require insurers to do more to coordinate care, and to pay hospitals and doctors based on the quality of outcomes rather than on the volume of procedures.
That could make the state "tougher to crack into as insurers align more closely (or even exclusively) with health systems," Cherry said.
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The only national Medicaid-focused insurer attempting to break into Pennsylvania, which started Medicare HMOs in 1997, is Centene Corp., a St.
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