Rural Hospitals and the Medicare (Dis)Advantage Ripoff
Rural Hospitals and the Medicare (Dis)Advantage Ripoff
About a year ago, I wrote about the problems that hospitals were having with payments from Medicare (Dis)Advantage (MA) in my piece titled "Medicare (Dis)Advantage - Even Hospitals Don’t Like It." Now, in a report from KFF Health News, rural hospitals are finding they can no longer afford to contract with Medicare Advantage insurers because MA pays less than other insurers for the same services; and they pay less so that they (MA) can pocket the difference. So, if those of you in rural areas were uninformed about, or gullible enough, to have signed on with an MA, the unapologetic grand theft "insurers," you may no longer be able to use that rural hospital because they've dropped your MA contract. Worse, if the preponderance of those rural patients have Medicare (Dis)Advantage, that rural hospital may have to close entirely. Perversely, if rural seniors continue to move into MA, they may be condemning their non-Medicare-insured neighbors to a medical care desert as hospitals and clinics have to close their doors due to MA's opaque and confiscatory business practices. From KFF:
Carrie Cochran-McClain, chief policy officer at the National Rural Health Association, said Medicare Advantage is particularly challenging for small rural facilities designated critical access hospitals. Traditional Medicare pays such hospitals extra, but the private insurance companies aren’t required to do so.
“The vast majority of our rural hospitals are not in a position where they can take further cuts to payment,” Cochran-McClain said. “There are so many that are just really in a precarious financial spot.”
Given that Medicare services are now under the control of whack-a-doodle TV doctor, Mehmet Oz, there is no telling what awaits our elderly under Medicare Advantage or even Traditional Medicare itself. Oz has been a great supporter of MA although during his confirmation hearings he voiced some concerns about "MA's cost to taxpayers." It is difficult to discern if this is a legitimate stance on his part or just some argle-bargle to mollify Congress to gain confirmation. Time will tell, but it may already be too late for some hospitals and MA insured.
As I said at the top of the article, if Elon and his Muskrats want to go after fraud, waste, and abuse they can start with eliminating Medicare (Dis)Advantage, while returning all those participants to Traditional Medicare. I do not exagerate in claiming that Musk could truthfully and quite easily add a few hundred billion dollars to their cost savings portfolio. Such action would also eliminate unnecessary "managerial" interference such as prior authorization, late payments (or no payments), and refusal of service by declaring the physician-directed treatment is not medically necessary. This interference is also, to a great degree, the cause of not only burnout of physicians but also moral injury that I wrote about a year ago in Moral Injury Links Medicare Advantage Physicians To Combat Veterans. The cascading negative effects of MA are financial, physical, psychological, and moral. Intiated by Bush II and continuing unabated under Obama, Trump 45 and Biden, MA is a poison to the nation's health care.
1 Comment, most recent 9 days ago