Monday, December 4, 2023
HomeEconomyRural hospitals reject health insurance discounts? – Healthcare Economist

Rural hospitals reject health insurance discounts? – Healthcare Economist






This may be the case. Modern Medical Report:

Last month, the St. Charles Health System threatened to cut ties with all Medicare Advantage plans over the next year, a move that would prevent an estimated 26,000 local beneficiaries from traveling to hospitals less than 100 miles away.
“The reality of Medicare Advantage in Central Oregon is that it does not deliver on its promise,” St. Charles Health System CEO Dr. Steve Gordon wrote in a press release at the time. “A plan designed to promote seamless and higher-quality care instead became a patchwork of administrative delays, denials and frustration,” he said. The Bend-based nonprofit declined to arrange for executives to accept interview.

St. Charles Health System isn’t alone.The article goes on to say that rural hospitals “are disproportionately affected by reimbursement cuts or Declined and delayed payments From Medicare Advantage plans because Medicare enrollees make up the majority of their patient population. “

Rural hospitals are particularly sensitive because the rate of rural beneficiaries enrolled in Medicare Advantage has increased from 11% to 40% of all rural Medicare beneficiaries between 2010 and 2023.

https://www.kff.org/medicare/issue-brief/medicare-advantage-enrollment-plan-availability-and-premiums-in-rural-areas/

On the positive side, plan choices have increased for rural Medicare Advantage beneficiaries, but this competition has led to MA plans targeting lower premiums and passing these lower costs onto hospitals with fewer reimbursements and reimbursement delays.

https://www.kff.org/medicare/issue-brief/medicare-advantage-enrollment-plan-availability-and-premiums-in-rural-areas/

My FTI Consulting Colleagues brother adam The article also cited the following:

“It’s like, ‘What’s the point of fighting over rates if we’re not even going to get paid?'” Broad said. “They make their money through commercial contracts. The margins are much smaller with Medicaid or Medicare, and if they don’t pay on time, properly or in full, then it creates disputes.”





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