- Center on Health Equity and Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Docs Protest as Insurers Trim Advantage Networks in Reaction to Rate Reductions
Many physicians around the country are getting notices from Advantage plans that they are being cut from private insurers' networks. In addition, some insurers have announced they are reducing their Advantage plan offerings in some states, trimming extra benefits and increasing patient cost sharing.
Dr. Mitchell Lipton learned that he might lose up to 25% of his patients when he received letters from UnitedHealthcare and EmblemHealth informing him that he was being terminated from their Medicare Advantage networks as of Jan. 1.
“Over a thousand patients are affected,” said Lipton, a solo practice internist and cardiologist in Brooklyn. “My staff is afraid someone is going to get fired.”
Many physicians around the country are getting notices from Advantage plans that they are being cut from private insurers' networks. In addition, some insurers have announced they are reducing their Advantage plan offerings in some states, trimming extra benefits and increasing patient cost sharing. UnitedHealthcare is shrinking its Advantage networks to 85% to 90% of their current size, said Jack Larsen, CEO of UnitedHealthcare Medicare & Retirement.
Read the full story here: http://bit.ly/Hj6MMr
Source: Modern Healthcare
Prices for care at hospital trauma centers vary across hospitals; drug shortages reached a record high during the first quarter of 2024; although 3 of the biggest makers of asthma inhalers pledged to cap out-of-pocket costs for some US patients at $35, these do not apply to daily inhalers used by the youngest kids with asthma.
Read More
Navigating Health Policy in an Election Year: Insights From Dr Dennis Scanlon
April 2nd 2024On this episode of Managed Care Cast, we're talking with Dennis Scanlon, PhD, the editor in chief of The American Journal of Accountable Care®, about prior authorization, price transparency, the impact of health policy on the upcoming election, and more.
Listen
The Biden administration recently launched the Global Health Security Strategy, a new effort to combat the spread of infectious diseases; lawmakers zeroed in on the risks of massive consolidation in health care during the first congressional hearing on the Change Healthcare hack; the FDA recently announced the recall of a pair of heart devices linked to numerous deaths and injuries.
Read More
Exploring Medicare Advantage Prior Authorization Variations
March 26th 2024On this episode of Managed Care Cast, we're talking with the authors of a study published in the March 2024 issue of The American Journal of Managed Care® about their findings on variations in prior authorization use across Medicare Advantage plans.
Listen
