Breaking Up Isn't Hard to Do

[somarco]

Nearly half of health systems are considering dropping Medicare Advantage plans

Nearly half of health systems are considering dropping Medicare Advantage plans

"Onerous" authorization requirements and high denial rates have health systems considering whether to drop Medicare Advantage plans.

www.beckershospitalreview.com

According to the report, 16% of health systems are planning to stop accepting one or more Medicare Advantage plans in the next two years. Another 45% said they are considering the same but have not made a final decision.

REBUTTAL . . .

Sachin Jain, MD, CEO of SCAN Group — one of the nation's largest nonprofit Medicare Advantage companies — cautioned health systems that dropping Medicare Advantage plans is a short-term trend that is "going to backfire in a big way for these large health systems."

 

[Newby]

Nearly half of health systems are considering dropping Medicare Advantage plans

Nearly half of health systems are considering dropping Medicare Advantage plans

"Onerous" authorization requirements and high denial rates have health systems considering whether to drop Medicare Advantage plans.

www.beckershospitalreview.com

According to the report, 16% of health systems are planning to stop accepting one or more Medicare Advantage plans in the next two years. Another 45% said they are considering the same but have not made a final decision.

REBUTTAL . . .

Sachin Jain, MD, CEO of SCAN Group — one of the nation's largest nonprofit Medicare Advantage companies — cautioned health systems that dropping Medicare Advantage plans is a short-term trend that is "going to backfire in a big way for these large health systems."

And by “backfire” they mean make them much more profitable?

 

[somarco]

And by “backfire” they mean make them much more profitable?

Paging Dr Sachin . . . Emergency. Come right away

 

[axeman462]

And by “backfire” they mean make them much more profitable?

Except for the fact that would be 110% inaccurate.
My God, the inaccuracies you MSOs spread is down right criminal. Get your facts right

 

[rmhaire]

Except for the fact that would be 110% inaccurate.
My God, the inaccuracies you MSOs spread is down right criminal. Get your facts right

When you can't agree, follow the Bee

Opinion: We Must Hand Control Of Our Healthcare Over To The Most Trustworthy Entity Of All: The Government

The healthcare crisis has come to a head. Rising costs, woeful insurance coverage, and inflated drug prices are devastating millions throughout our land. All across the nation, people are waking up to the fact that we simply can’t let this issue be swept under the rug any longer.

babylonbee.com

 

[axeman462]

When you can't agree, follow the Bee

Opinion: We Must Hand Control Of Our Healthcare Over To The Most Trustworthy Entity Of All: The Government

The healthcare crisis has come to a head. Rising costs, woeful insurance coverage, and inflated drug prices are devastating millions throughout our land. All across the nation, people are waking up to the fact that we simply can’t let this issue be swept under the rug any longer.

babylonbee.com

That website is almost prophetic

 

[sshafran]

HFMA reminds me of a 3rd party claims assistance company we used when I was doing roofing and siding. When a claim was involved we'd send them documentations and they'd find every little thing they could think of to add to the claim so that we'd get more $.

They got paid a percentage of the spread between the original scope and the contractor-friendly scope.

Everything was "technically" legitimate. It allowed us to put on a roof at 20-30% more when insurance was involved compared to retail.

"Labor hours to move patio furniture... Tarp cost to cover patio furniture... Labor to cover plants for landscape protection... Cleaning fee for driveway after dumpster... Nail sweep fee..."

All technically legit and helpful for profit. But we weren't charging for that on retail jobs "Mrs. Smith, yes we'll take care of the patio furniture and move it over there."

Retail - it was less profit because Mr. Smith is going to go with the competition if I try to charge him $150 to move his patio table and chairs...

Not unlike $45 for 3 Tylenols at the hospital...

 

[sshafran]

HFMA reminds me of a 3rd party claims assistance company we used when I was doing roofing and siding. When a claim was involved we'd send them documentations and they'd find every little thing they could think of to add to the claim so that we'd get more $.

They got paid a percentage of the spread between the original scope and the contractor-friendly scope.

Everything was "technically" legitimate. It allowed us to put on a roof at 20-30% more when insurance was involved compared to retail.

"Labor hours to move patio furniture... Tarp cost to cover patio furniture... Labor to cover plants for landscape protection... Cleaning fee for driveway after dumpster... Nail sweep fee..."

All technically legit and helpful for profit. But we weren't charging for that on retail jobs "Mrs. Smith, yes we'll take care of the patio furniture and move it over there."

Retail - it was less profit because Mr. Smith is going to go with the competition if I try to charge him $150 to move his patio table and chairs...

Not unlike $45 for 3 Tylenols at the hospital...

If I sound like a Millennial at times - I technically am (geriatric millennial - '84). I generally distrust the medical community big business model.

I don't necessarily think the insurance carriers are a bunch of good Samaritans either, though I may not rag on them as frequently.

 

[hockeyday]

Except for the fact that would be 110% inaccurate.
My God, the inaccuracies you MSOs spread is down right criminal. Get your facts right

Come on now he's a 1 trick pony,

 

[hockeyday]

Nearly half of health systems are considering dropping Medicare Advantage plans

Nearly half of health systems are considering dropping Medicare Advantage plans

"Onerous" authorization requirements and high denial rates have health systems considering whether to drop Medicare Advantage plans.

www.beckershospitalreview.com

According to the report, 16% of health systems are planning to stop accepting one or more Medicare Advantage plans in the next two years. Another 45% said they are considering the same but have not made a final decision.

REBUTTAL . . .

Sachin Jain, MD, CEO of SCAN Group — one of the nation's largest nonprofit Medicare Advantage companies — cautioned health systems that dropping Medicare Advantage plans is a short-term trend that is "going to backfire in a big way for these large health systems."

84% still in the game