Ohio health system dropping Anthem, Humana Medicare Advantage plans

Zanesville, Ohio-based Genesis Healthcare System is dropping Anthem and Humana Medicare Advantage plans in 2024.

The one-hospital system covers a six-county region of southeastern Ohio and said Oct. 18 it will still contract with Medicare Advantage plans from Aetna, Medical Mutual of Ohio, UnitedHealthcare, and Medigold, which is the MA plan from Livonia, Mich.-based Trinity Health. Genesis did not state a reason for its decision.

Hospitals and health systems nationwide have increasingly been ending contracts with MA plans, either altogether or with specific carriers. Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers. Some systems have noted that most MA carriers have faced allegations of billing fraud from the federal government and are being probed by lawmakers over their high denial rates.

Though some health systems are moving away from Medicare Advantage, others are partnering with payers, grocers or other systems to launch their own or expand existing MA plans for 2024.

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