Tag: Medicare Advantage
What to expect in 2025: Managed care trends and predictions
New president. New Congress. Decades old healthcare cost finger pointing. Payors and providers say change is needed. Yet there’s no consensus on how to achieve it. In our new report, we share...
More Medicare Advantage turmoil
Medicare Advantage plans face growing scrutiny and rejection by providers due to payment challenges and administrative complexities, prompting hospitals to reassess contracts and seek strategic support for managed care negotiations...
UnitedHealth Group – The “Death Star” of U.S. healthcare
UnitedHealth Group's aggressive acquisition strategy, particularly in areas where it dominates Medicare Advantage, highlights its influence over the U.S. healthcare system and underscores the need for providers to understand and...
So much Medicare Advantage noise, so little time
Medicare Advantage plans have grown significantly, benefiting insurers through higher taxpayer costs driven by coding intensity, while raising concerns about their effectiveness and necessitating strategic evaluation by providers and government...
Three things you need to know about Medicare Advantage today
Medicare Advantage's rapid growth is straining hospitals and health systems due to low reimbursement rates, rising denials, and payment disputes, requiring providers to adopt data-driven strategies and proactive contract negotiations...
2023 revenue challenges: Turning the tide in 2024
In 2023, hospitals and health systems faced financial pressures from Medicaid redeterminations, Medicare Advantage's rapid growth, and shifting expectations of commercially insured patients, requiring proactive strategies in reimbursement, contract negotiations,...
Shifts in healthcare, provider hurdles, & the flywheel effect
UnitedHealth Group's vertically integrated model leverages its assets to drive profitability while straining providers through low reimbursement rates, fueling industry-wide tension and highlighting the need for proactive strategies to address...