HealthLeaders Media May 7, 2024
Payers are shifting their priorities in the MA space.
Medicare Advantage often takes the spotlight and next year will bring about some big changes that are sure to keep it there. Payers were up in arms over Medicare Advantage base rate cuts that will drop to 0.16% in 2025. Payers fought for higher payments, but CMS finalized this rule in April.
With this lower reimbursement rate and high medical costs, some payers are adjusting their strategies and looking at profitability and margins over membership growth.
Atena is looking to implement this strategy as it pulls out of less profitable counties. With disappointing first quarter results, Aetna CEO Brain Kane said the company will prioritize profitability over membership growth.
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