One-third of Medicare beneficiaries are not notified when a provider drops out of network

HealthMine surveyed 500 Medicare plan members on a variety of topics related to healthcare including provider and payer communication and interaction as well as health management.

Here's four insights from the survey:

1. Sixty-nine percent of respondents said their payer notifies them if a provider is dropping out of network, while 31 percent do not receive a notification.

2. A majority (53 percent) of Medicare recipients said their payer does not interact with a provider after a visit. Seventeen percent indicated their payer follows up with providers to inquire about quality of care, while 32 percent said the payer follows-up to discuss coverage and claims.

3. Fifty-two percent of Medicare beneficiaries were unsure if their health plan provided all their health information to providers before a visit. Thirty percent indicated they'd like their payer to do so, while 17 percent said their payer already does.

4. Eighty-six percent of respondents said a provider has the ability to best manage their health. While 10 percent of respondents said a relative gave the best recommendations.

HealthMine President and CEO Bryce Williams said in a release, "This data indicates that plans can improve communication with members, so members know when changes are made in the provider network. For plans, they are much more than a claims processor — they are the center of every member's health information. In this central role, it's imperative to over deliver in communications to Medicare members and meet them on their terms."

Copyright © 2024 Becker's Healthcare. All Rights Reserved. Privacy Policy. Cookie Policy. Linking and Reprinting Policy.

 

Featured Webinars

Featured Whitepapers

Featured Podcast