Medicare Advantage in the headlines: 10 recent updates

Health systems have considered dropping Medicare Advantage plans, and insurers are making efforts to cut back on prior authorizations in the program. 

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Here are 10 updates about the program Becker’s has reported since Aug. 14. 

  1. More employers are offering health benefits to retired employees through Medicare Advantage. Here are some employers making the switch from traditional Medicare to MA. 
  1. San Diego-based Scripps Health is the latest health system weighing the costs and benefits of Medicare Advantage. Two of the system’s medical groups — Scripps Coastal Medical Center and Scripps Clinic — notified Medicare Advantage insurers in the area they intended to terminate their contracts in January. The system is still open to negotiating new contracts with the six Medicare Advantage plans it currently accepts, according to reporting from the San Diego Union-Tribune. 

  1. SCAN Health Plan, UPMC and Humana have some of the top-rated Medicare Advantage plans in the country’s largest markets, according to J.D. Power. Here is J.D. Power’s top-rated plans in five markets.
  2. Medicare Advantage enrollees were less likely to report receiving post-acute care after hospitalization than their counterparts in traditional Medicare, a study in JAMA Health Forum found. 
  1. UnitedHealthcare is cutting 20 percent of its prior authorizations in two waves. The first cuts take effect Sept. 1 and the second phase goes into effect Nov. 1. Here are the number of cuts UnitedHealthcare is making to its Medicare Advantage prior authorization requirements, broken down by category.
  2. Co-branded Medicare Advantage plans shared between two organizations are nothing new, but payers continue to dive into new partnerships in an effort to reach more niche populations across a variety of settings.These are five new co-branded MA plans announced or launched by payers this year.
  1. Select Health and Kroger Health are launching co-branded Medicare Advantage plans across four states in 2024.
  1. Presbyterian Health Plan received an estimated $2.2 million in Medicare Advantage payments in 2017 and 2018, according to an audit from HHS’ Office of Inspector General. 
  1. Bend, Ore.-based St. Charles Health System is considering dropping all Medicare Advantage plans and is encouraging its senior patients not to enroll in the private Medicare plans during the next open enrollment period. 
  2. A New York State Supreme Court judge permanently blocked the implementation of New York City’s plan to switch 250,000 retired city employees from traditional Medicare to an Aetna Medicare Advantage plan. 
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