Indiana system dropping Aetna, Humana Medicare Advantage plans

Community Healthcare System is dropping two Medicare Advantage plans, citing unreasonable denials and delayed payments, The Times of Northwest Indiana reported Feb. 20. 

The Munster, Ind.-based system will go out of network with Humana and Aetna's Medicare Advantage plans June 1, according to its website. 

"Administration of Medicare Advantage plans makes it difficult to provide care to patients because of unreasonable denials and delayed payments," the system told The Times of Northwest Indiana. "Community Healthcare System has decided to discontinue to participate with Aetna and Humana Medicare Advantage plans." 

A spokesperson told the outlet Medicare Advantage plans deny access to post-acute providers and care recommended by patients' physicians. 

The system will remain in-network with other Medicare Advantage plans, including UnitedHealthcare, Anthem and Cigna, according to its website. 

Community Healthcare System operates three Indiana hospitals and a stroke and rehabilitation center. 

Medicare Advantage members affected by the split can enroll in another Medicare Advantage plan or traditional Medicare through March 31, the spokesperson said. 

Several other health systems have dropped Medicare Advantage plans in recent months, often citing excessive prior authorization denial rates and slow payments from insurers. Since September, Becker's has reported at least 15 health systems dropping some or all MA contracts. 

Health systems are becoming choosier about which Medicare Advantage plans they contract with, Shannon Drotning, market president for Providence Health Plan's consumer and specialty division, told Becker's in January. 

"Hospitals are definitely becoming more discerning about which Medicare Advantage plans they contract with, though it's not happening in every single market. At a high level and as time goes on, I think we're going to see higher-quality plans on the market, though maybe fewer of them," Ms. Drotning said. 

Becker's has reached out to Aetna, Humana and Community Healthcare System and will update this article if more information becomes available. 

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