Healthcare DIVE March 21, 2024
Insurers could increase claims denials and engage in aggressive contract negotiations with hospitals as profitability in the popular plans declines.
Dive Brief:
- Hospitals could face increased revenue risks due to increasing enrollment in Medicare Advantage, according to a report released Tuesday by credit agency Moody’s Ratings.
- Insurers could negotiate more aggressive rates, increase claims denials and delay care authorization in the face of declining MA plan profitability. Consolidation in the MA market is expected to intensify the impact, as hospitals may have fewer options for contracts, Moody’s said.
- However, new rules from the CMS could mitigate some of the challenges posed by MA growth, according to the report.
Dive Insight:
MA plans have grown increasingly popular in recent...
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