Health systems considering dropping Medicare Advantage: What ASCs need to know 

Nearly half of health systems are considering dropping Medicare Advantage, according to a survey from the Healthcare Financial Management Association and Eliciting Insights. 

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Here are five things to know:

1. Of the 135 health system CFOs surveyed, 16% are planning to stop accepting one or more Medicare Advantage plans in the next two years and another 45% said they are considering doing so.

2. Nineteen percent stopped accepting one or more Medicare Advantage plan in 2023. 

3. The report cited onerous authorization requirements and high denial rates as the driving forces behind health systems’ frustration toward Medicare Advantage. 

4. Despite tensions with some health systems, the Medicare Advantage program had a 95% quality satisfaction rating among enrolled members in 2023.

5. Health system-owned Medicare Advantage enrollment continues to grow, but providers’ share of the national market sits at 13%, compared to 17% in 2019, according to a recent analysis from Chartis.

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