That can be the case. Fashionable Healthcare experiences:
Remaining month, St. Charles Well being Gadget 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 health center 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 Gadget CEO Dr. Steve Gordon wrote in a information liberate on the time. “A program meant to advertise seamless and better high quality care has as a substitute transform a fragmented patchwork of administrative delays, denials and frustrations,” he mentioned. The Bend-based nonprofit corporate declined to make an govt to be had for an interview.
St. Charles Well being Gadget isn’t the one one. The object is going on to mention that rural hospitals are “disproportionately suffering from components akin to repayment 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 in particular 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 sure facet, plan selection for rural Medicare Benefit beneficiaries has higher, however this pageant has lead MA plans to try to decrease premiums and go thru those decrease prices to hospitals with decrease repayment and repayment delays.
My FTI Consulting colleague Adam Broder was once additionally cited within the article, mentioning:
“It’s like, ‘What’s the purpose of preventing about charges if we will be able to’t even receives a commission?’” Broder mentioned. “They earn a living 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.”