With more Medicare beneficiaries nationwide on Medicare Advantage (MA) plans rather than Traditional Medicare for the first-time last year, the shift is starting to hit Leading Health Systems' bottom lines. As MA payers push down realized revenue with prior authorizations and claims denials, we've seen more systems consider dropping some or all MA contracts. Yet, MA patients now also comprise 70%+ of all Medicare patients in some markets—which makes it difficult to cut contracts without impacting volumes or community needs. In this session, we provide an overview of what's happening in the MA market, a prediction of what will happen in the next few years, and a discussion of strategic responses.
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