Quote:
Originally Posted by Aces4
Medical centers are moving away from Medicare Advantage primarily due to issues with low reimbursement rates, excessive administrative burdens like prior authorization denials, delayed payments from insurers, and strict clinical guidelines that limit their ability to provide optimal care, making it financially challenging to participate in these plans.
From Becker's hospital review:
Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers.
In 2023, Becker's began reporting on hospitals and health systems nationwide that dropped some or all of their Medicare Advantage contracts.
"Medicare Advantage provides health coverage to more than half of the nation's older adults, but some hospitals and health systems are opting to end their contracts with MA plans over administrative challenges.
Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers."
Remember, it's easy to move to Medicare Advantage but it's getting regular Medicare coverage which is difficult when you want to change to better coverage. People can be very blind when a few goodies are dangled in front of their eyes. They can't see the ogre in the background.
The government is working constantly to cut Medicare costs and services for the elderly. Even under regular Medicare coverage they have instituted "value based programs" to insureds claiming "Our value-based programs are important because they’re helping us move toward paying providers based on the quality, rather than the quantity of care they give patients". Which translates to fewer services to save money, IMHO.
Seniors pay close attention, this pertains to all of us.
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Again, you're painting with a broad brush. All MA plans are not the same, and many people I know personally did it the exact same way as us. They did lots of research and made an educated decision. MA plans aren't going away. And the good ones will be around for a long time. Imo.