Becker's Healthcare May 24, 2024
As some major Medicare Advantage insurers look to shrink enrollments and exit markets, others say reimbursement cuts from CMS are a chance to refocus strategies and provide a better product to their members.
“If reimbursements are cut, it forces you to do more with less,” SCAN Group CEO Sachin Jain, MD, told Becker’s. “It forces you to be sharper and refine your thinking.”
At the beginning of 2024, CMS began implementing Medicare Advantage risk adjustment changes, which the health insurance largely opposed. The changes are being phased in over three years.
Facing lower margins and rising utilization rates, large MA insurers such as CVS Health and Humana have said they will prioritize margins over growing their membership, even eyeing market...
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