Hospitals aren't breaking up with Medicare Advantage, UnitedHealth says

Though some contract negotiations with providers came "down to the wire" last year, UnitedHealthcare executives said the payer did not see more contract splits than usual in 2023. 

Brian Thompson, CEO of UnitedHealthcare, told investors on a Jan. 12 call the insurer did not see more contract disruptions than in previous years in 2023. 

"Specific to the Medicare Advantage space, we did have some deals that came down to the wire. That did have some impact on [the annual enrollment period]," Mr. Thompson said. 

UnitedHealthcare executives said they expect to see the majority of the insurer's Medicare Advantage growth in 2024 outside of the annual enrollment period. UnitedHealth Group CEO Andrew Witty told investors UnitedHealthcare added around 100,000 new members during the annual enrollment period, which runs from October to December. 

Mr. Thompson said he expects membership to increase now that more network agreements with providers are in place. 

Becker's reported at least 15 hospitals and health systems that dropped some or all Medicare Advantage plans in 2023. In the first weeks of 2024, UnitedHealthcare's MA plans went out of network with Little Rock, Ark.-based Baptist Health and Greenville, S.C.-based Prisma Health.

Health systems have cited excessive prior authorization denial rates and slow payments from insurers as reasons for dropping MA plans. 

During a panel at the Becker's 11th CEO+CFO Roundtable in November, Will Bryant, CFO of Chapel Hill, N.C.-based UNC Health, said his system has forged partnerships with payers but still experiences challenges with Medicare Advantage plan denials. While the health system aims to expand partnerships with payers in some areas, they'll likely experience contraction with Medicare Advantage plans that aren't performing well, and aren't good partners for the system, he said. 

"We will ultimately pick a couple of partners going forward, and I think a lot of health systems are going to do this," said Mr. Bryant. "They're going to be the partners who act like partners and not who deny care in order to bolster their billions of dollars of quarterly earnings."

Mr. Witty told investors the vast majority of contract negotiation disputes with providers are resolved without disruptions to patients' care. 

"We're working really hard on behalf of our clients, on behalf of patients, on behalf of government to make sure we're getting the very best cost associated for the care delivered," Mr. Witty said. "It's important that negotiation is robust." 

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


Top 40 articles from the past 6 months