Sunday, September 24, 2023

Rural hospitals rejecting Medicare Benefit? – Healthcare Economist


That can be the case. Trendy Healthcare experiences:

Closing month, St. Charles Well being Machine threatened to chop ties with all Medicare Benefit plans subsequent 12 months, a transfer that would depart an estimated 26,000 native beneficiaries with out get entry to to a clinic not up to 100 miles away.
“The truth of Medicare Benefit in central Oregon is that it simply hasn’t lived as much as the promise,” St. Charles Well being Machine CEO Dr. Steve Gordon wrote in a information unencumber on the time. “A program supposed to advertise seamless and better high quality care has as a substitute grow to be a fragmented patchwork of administrative delays, denials and frustrations,” he stated. The Bend-based nonprofit corporate declined to make an government to be had for an interview.

St. Charles Well being Machine isn’t the one one. The object is going on to mention that rural hospitals are “disproportionately suffering from elements akin to compensation cuts or denied and not on time bills from Medicare Benefit plans as a result of Medicare enrollees make up maximum in their affected person populations.”

Rural hospitals are specifically delicate as a result of enrollment in Medicare Benefit amongst rural beneficiaries has grown from 11% to 40% of all rural Medicare beneficiaries between 2010 and 2023.

At the certain facet, plan selection for rural Medicare Benefit beneficiaries has higher, however this festival has lead MA plans to attempt to decrease premiums and cross via those decrease prices to hospitals with decrease compensation and compensation delays.

My FTI Consulting colleague Adam Broder was once additionally cited within the article, mentioning:

“It’s like, ‘What’s the purpose of combating about charges if we will’t even receives a commission?’” Broder stated. “They make cash at the business contracts. The margins are simply such a lot smaller from Medicaid or Medicare, and if they are able to’t receives a commission on time or correctly or within the complete quantity, then that’s going to result in a dispute.”


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