Medicare Advantage is in an awkward place. On the one hand, the alternative to traditional Medicare is still popular among consumers, who have been lured by the promises of lower out-of-pocket costs and increased supplemental benefits. On the other hand, Medicare Advantage profitability is on the decline, as shown in recent quarterly reports from the large insurers. The headwinds, executives said during recent earnings calls, have been due to greater than expected utilization of benefits and lower than expected reimbursement from the government. Adding to MA’s margin challenges are providers who are making the decision to cut their ties with MA plans rather than deal with delays in prior authorization and claims payments.
Read the full article: Medicare Advantage Struggling under Low Payment, High Utilization //
Source: https://www.healthcarefinancenews.com/news/medicare-advantage-struggling-under-payment-utilization-concerns