Medicare Advantage’s ‘unrealized’ potential

Becker's Healthcare September 4, 2024
Laura Dyrda

Health system C-suites have mixed feelings about Medicare Advantage plans. Many are frustrated with the high denial rates and low coverage; some have even cut ties with MA plans.

But others see a disruptive force that could have a positive impact on healthcare, if executed correctly.

“I think Medicare Advantage has enormous potential, but that it’s currently largely unrealized,” Greg Poulsen, senior vice president and chief policy officer at Intermountain, on an episode of the “Becker’s Healthcare Podcast.” “The reason that it’s not been utilized as effectively as it could be, or should be, is that although the federal government CMS pays Medicare Advantage plans on a per capita basis, that’s not the way the plans by and large pay...

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