New York medical group drops Humana Medicare Advantage across 70 practices

Community Care Physicians, a Latham, N.Y.-based multispecialty medical group, went out of network with Humana Medicare Advantage plans on March 13.

"Unfortunately, the requirements imposed by Humana have become increasingly cumbersome," the organization wrote to patients in November. "We need insurance partners who understand our patient and provider needs, allow for independent provider decision-making, and don’t have burdensome processes that delay care."

CCP has more than 1,800 employees, including more than 420 clinicians, across 70 practices in New York's Capital Region. The group is affiliated with Capital District Physicians' Health Plan and also still accepts Medicare Advantage patients with plans from MVP, Aetna, UnitedHealthcare, Centene's Fidelis and local BCBS affiliates.

Providers and health systems around the country have been increasingly pushing back against Medicare Advantage, citing excessive prior authorization denial rates and slow payments from insurers.

According to a January report from the Healthcare Financial Management Association, 16% of health systems are planning to stop accepting one or more Medicare Advantage plans in the next two years. Another 45% said they are considering the same but have not made a final decision. In 2023, Becker's reported on at least 15 hospitals dropping some or all MA contracts.

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.


Top 40 articles from the past 6 months