Becker's Healthcare January 23, 2025
Medicare Advantage represents more than 55% of the Medicare population, but the program has faced mounting criticism from some health systems, particularly over administrative hurdles such as prior authorization denials and slow payment processes.
Dozens of health systems have terminated Medicare Advantage contracts in recent years, with a select few systems terminating all MA contracts entirely.
Contract disputes between payers and providers came to a head in 2024. According to data from FTI Consulting, in the fourth quarter of 2024, there were 50 contract disputes covered by a traditional media outlet, the highest since the firm began tracking disputes in early 2022. Of these 50 disputes, 32 (64%) involved Medicare Advantage plans.
“Medicare Advantage has its advantages for beneficiaries —...
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