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Rural hospitals question whether they can afford Medicare Advantage contracts • South Dakota Searchlight
Rural hospital leaders are questioning whether they can continue to afford to do business with Medicare Advantage companies, and some say the only way to maintain services and protect patients is to end their contracts with the private insurers.
southdakotasearchlight.com
In recent years, average Medicare Advantage reimbursements to rural hospitals were about 90% of what traditional Medicare paid, according to a new report from the American Hospital Association. And traditional Medicare already pays hospitals much less than private plans, according to a recent study by Rand Corp., a research nonprofit.
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.
Mehmet Oz — doctor, former talk show host, and President Donald Trump's nominee to lead the Centers for Medicare & Medicaid Services — has promoted and worked for the private Medicare industry and called for "Medicare Advantage for all." But during his recent confirmation hearing, he called for more oversight as he acknowledged bipartisan concerns about the plans' cost to taxpayers and their effect on patients.
Cochran-McClain said some Republican lawmakers want to address these issues while supporting Medicare Advantage.
"But I don't think we've seen enough yet to really know what direction that's all going to take," she said.
