In the face of rising MA plan denials, health systems must engage in strategic, aggressive escalation

Becker's Healthcare October 17, 2024
In collaboration with CorroHealth

Relationships between providers and Medicare Advantage (MA) plans have become more strained as payers aggressively deny claims. To ensure providers’ financial sustainability and patients’ access to care, health systems must implement new strategies to maintain their current revenue from MA plans and to generate new sources of revenue.

During a Becker’s Hospital Review webinar sponsored by CorroHealth, Jerilyn Morrissey, MD, chief medical officer, and Sam Dominik, senior vice president — both of CorroHealth — described challenges providers face associated with Medicare Advantage and recommended strategies for dealing with these challenges.

Five key takeaways were:

1. As more Medicare beneficiaries enroll in MA plans, providers are experiencing revenue and cost pressures. Data from KFF shows that more than 50% of the...

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