Hospitals Dropping Medicare Advantage
Medicare Advantage (MA) has long been a popular choice among Medicare enrollees, offering hospital and medical coverage and often, prescription drug, vision, and dental services. However, as a broker, I’ve recently noticed a growing trend among hospitals and health systems nationwide reconsidering their acceptance of MA plans for care in their facilities.
Rising Concerns with Medicare Advantage
Medicare Advantage, while beneficial for many, has come under scrutiny for several reasons. One of the primary concerns, as I’ve heard from my own clients, is the high rates of prior authorization denials and slow payments from insurers. This has led to significant delays and financial burdens on healthcare providers.
Hospital and Health Systems Reaction
The financial strain on health systems which accept MA contracts is becoming increasingly evident. For instance, Scripps Health, a major hospital system in Southern California, anticipates a staggering loss of $75 million this year on its MA contracts. This has led to decisions like Scripps and St. Charles Health System dropping or reconsidering their MA contracts.
Other notable health systems and hospitals have also taken similar steps:
Scripps Health in San Diego began notifying patients of its decision to terminate Medicare Advantage contracts for its integrated medical groups, affecting more than 30,000 seniors in the region.
Mayo Clinic in Scottsdale, Arizona, warned patients about its decision to limit acceptance of most MA plans.
Samaritan Health Services in Oregon decided to end its contracts with UnitedHealthcare.
St. Charles Health System in Bend, Oregon, is not only considering dropping all Medicare Advantage plans but is also urging its senior patients to reconsider enrolling in private Medicare plans.
The Impact on Patients
The decisions made by hospitals and health systems directly impact seniors enrolled in MA plans. Many face the potential burden of having to switch plans or confront higher out-of-pocket costs. As these shifts continue, it's crucial for seniors to be informed about their healthcare choices.
What to Do Now?
For those affected by these changes or those considering their Medicare options, there are alternatives to consider. Medicare Supplements (Medigap) offer a viable solution, filling gaps in Original Medicare coverage and often providing a more predictable cost structure, with a variety of letter designated (G, N, etc.) plans available. Nearly all of my Medicare Supplement clients report high satisfaction and peace of mind with these plans.
Enrollees should research their current coverage and options and consult with a local broker to understand MA coverage changes and identify the best course of action to ensure quality healthcare. Remember, you're not on this journey alone. Our licensed insurance agents are here to offer personalized assistance and ensure you get the optimal healthcare coverage; if you have questions or concerns, please reach out to us for guidance.
