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Docs Protest as Insurers Trim Advantage Networks in Reaction to Rate Reductions
Many physicians around the country are getting notices from Advantage plans that they are being cut from private insurers' networks. In addition, some insurers have announced they are reducing their Advantage plan offerings in some states, trimming extra benefits and increasing patient cost sharing.
Dr. Mitchell Lipton learned that he might lose up to 25% of his patients when he received letters from UnitedHealthcare and EmblemHealth informing him that he was being terminated from their Medicare Advantage networks as of Jan. 1.
“Over a thousand patients are affected,” said Lipton, a solo practice internist and cardiologist in Brooklyn. “My staff is afraid someone is going to get fired.”
Many physicians around the country are getting notices from Advantage plans that they are being cut from private insurers' networks. In addition, some insurers have announced they are reducing their Advantage plan offerings in some states, trimming extra benefits and increasing patient cost sharing. UnitedHealthcare is shrinking its Advantage networks to 85% to 90% of their current size, said Jack Larsen, CEO of UnitedHealthcare Medicare & Retirement.
Read the full story here: http://bit.ly/Hj6MMr
Source: Modern Healthcare
Varied Access: The Pharmacogenetic Testing Coverage Divide
February 18th 2025On this episode of Managed Care Cast, we speak with the author of a study published in the February 2025 issue of The American Journal of Managed Care® to uncover significant differences in coverage decisions for pharmacogenetic tests across major US health insurers.
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For Neuromuscular Disease Community, an Era of Opportunities and Threats
March 17th 2025Robert Califf, MD, former commissioner of the FDA, delivered a keynote address at the 2025 Muscular Dystrophy Association Clinical & Scientific Conference that highlighted the enormous opportunities for progress in neuromuscular disease care amid a changing policy environment.
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More Care Doesn't Equal Happier Patients in Traditional Medicare
March 17th 2025Data on care satisfaction, ease managing care, and out-of-pocket spending were the outcomes of interest for this new analysis that investigated the relationship between healthcare utilization and beneficiary experience within traditional Medicare.
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