Hospitals Divorce Medicare Advantage

[somarco]

a growing number of facilities around the country will not accept some or all MA patients in the new year, citing excessive prior authorization denial rates and slow payments from insurers. In their refusals, some systems have even pointed to allegations of billing fraud among MA carriers made by the federal government.

more than half of the nation's 65 million older adults are enrolled in Medicare Advantage, and more than half of those enrollees have annual incomes of less than $25,000.

"[Dropping MA] is a short-term trend that is going to backfire in a big way for these large health systems," he said. "You're a nonprofit system saying you're no longer going to accept the insurance that low-income people actually have. We'll see how that works out for you."
https://www.beckershospitalreview.c...-regret-their-medicare-advantage-divorce.html

 

[Northeast Agent]

Geisinger, based in central PA sent this last week:

Have clients with UnitedHealthcare Medicare, AARP or Humana Medicare Advantage networks? Beginning Jan. 1, 2024, WellSpan providers and hospitals will no longer be in network for them. That means if your clients with UnitedHealthcare Medicare, AARP or Humana Medicare Advantage networks go to WellSpan Health, they will pay out-of-network costs. Those are typically higher than in-network costs.

Make sure your clients have access to care when they need it. Encourage them to stay with WellSpan Health and receive generous benefits with a Geisinger Gold Medicare Advantage plan, like access to:

• Over 30,000 providers in Pennsylvania
• More than 180 hospitals
• Nearly 3,000 pharmacies

 

[Bob L]

I've got my PA Wellspan clients in Highmark BCBS plans. They're happy with them so far.