Becker's Healthcare December 19, 2023
The healthcare sector faces a critical juncture due to mounting macroeconomic challenges, particularly from the increasing complexities and financial pressures of Medicare Advantage Organization’s (MAO) reimbursement processes.
This situation is intensified as a significant portion of the population ages into Medicare. Dr. Jerilyn Morrissey, CMO at CorroHealth, notes a striking trend: “At the end of 2022, across the nation, as patients were electing their Medicare benefits, 50% were opting for Medicare Advantage Plans. This is a huge number.” This surge represents a significant macroeconomic turning point, giving MAOs more power and significantly influencing hospital finance and patient care strategies. This is further amplified by how hospitals utilize their key performance indicators (KPIs), such as denial rates, case mix index (CMI),...
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