Medicare Advantage - Breaking Up is Hard to Do

[somarco]

Though some contract negotiations with providers came "down to the wire" last year, UnitedHealthcare executives said the payer did not see more contract splits than usual in 2023.

Becker's reported at least 15 hospitals and health systems that dropped some or all Medicare Advantage plans in 2023. In the first weeks of 2024, UnitedHealthcare's MA plans went out of network with Little Rock, Ark.-based Baptist Health and Greenville, S.C.-based Prisma Health.

Health systems have cited excessive prior authorization denial rates and slow payments from insurers as reasons for dropping MA plans.

While the health system aims to expand partnerships with payers in some areas, they'll likely experience contraction with Medicare Advantage plans that aren't performing well, and aren't good partners for the system, he said.

"We will ultimately pick a couple of partners going forward, and I think a lot of health systems are going to do this," said Mr. Bryant. "They're going to be the partners who act like partners and not who deny care in order to bolster their billions of dollars of quarterly earnings."

Hospitals aren't breaking up with Medicare Advantage, UnitedHealth says

UnitedHealthcare executives assure investors that contract negotiations with providers in 2023 did not result in more disruptions than usual.

www.beckerspayer.com

Apology to Neil Sedaka . . . I just couldn't resist

 

[adjusterjack]

"We will ultimately pick a couple of partners going forward, and I think a lot of health systems are going to do this," said Mr. Bryant. "They're going to be the partners who act like partners and not who deny care in order to bolster their billions of dollars of quarterly earnings."

The pot calling the kettle black.

Hospitals commit fraud too.

N.J. hospital, investors agree to $30 million settlement over Medicare fraud

Operators of a Newark hospital and some of its investors will pay nearly $30.6 million in a settlement with the federal government after the facility was accused of falsifying Medicare reports and getting unjustified reimbursements. The hospital abused Medicare’s outlier payment system, in...

www.insurance-forums.com

 

[straightnochaser]

You should give it a try, you're obsessed.

 

[Millwood]

Number of Nongovernment Not-for-Profit Community Hospitals: 2,978

Number of Investor-Owned (For-Profit) Community Hospitals: 1,235

2978+1235 = 4213

15/4213 = .3%

Hospital System could mean a health system with 75 hospitals. Not a enough information to draw that conclusion (.3%).

 

[Millwood]

I don't know. Not interested enough to do that leg work. But I'f you are going to make that precise of a statement you should.

 

[somarco]

Referenced article split the baby but some folks missed that.

If someone wants more granularity, there are over 4M results from a G search for hospitals dropping medicare advantage 2023

 

[Midlevel]

Referenced article split the baby but some folks missed that.

If someone wants more granularity, there are over 4M results from a G search for hospitals dropping medicare advantage 2023

Good God, it’s gonna be a long year. Might be 2 years before all 4M are posted here.

 

[Millwood]

Once again you're jumping to conclusions.
Don't have a single buddy on here.
And you were the one that drew very precise detailed mathematic computations "with intentionally vague " article.

I took the information that the article provided. Which was intentionally vague. If you want precision tell your butt buddy to post more precise articles.

 

[somarco]

This place is like a 3rd grade schoolyard. When you run out of ammo to defend your position you result to name calling.

So juvenile.

I am surprised no one has called another a big doody head.

The reading comprehension level for some folks is definitely third grade level.

 

[Special Agent]

your the doody head Sharty Mcpoopypants