Healthcare Finance News December 18, 2024
Jeff Lagasse

Higher-than-expected utilization and low reimbursement have challenged the program in 2024.

The past couple of years have seen the sharp ascendancy of Medicare Advantage to now include more than half of all beneficiaries with Medicare coverage.

The alternative to the traditional fee-for-service Medicare has proven popular with consumers due to lower out-of-pocket costs and its additional benefits, such as prescription drug, vision and dental coverage.

But for the first time, the program, also known as Part C, is suffering setbacks as well as growth.

Medicare Advantage profitability is on the decline, as shown in recent quarterly reports from the large insurers. The headwinds, executives said during recent earnings calls, have been due to greater than expected utilization of benefits...

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