United Healthcare Dropping Medicare Docs. United Healthcare has notified 10-15% of its Medicare Advantage Providers that they will be dropped from their network this February.
Providers are calling the move by the insurer to increase their star rating in order to increase Medicare (CMS) reimbursements. Quality-incentive payments to insurers under CMS’ five-star rating system for health plans will get stricter in 2014, eliminating payments to any plan earning fewer than four stars. Over the past two years, plans with 3 or 3.5 stars received payments.
According to today’s WSJ article UnitedHealth Culls Doctors From Medicare Advantage Plans – The company said it is managing its network, in part, to provide more value for members, particularly given Medicare’s new five-star rating system that ties bonus payments for insurers to certain measures of cost and quality.”That’s what’s driving our actions,” said Austin Pittman, president of UnitedHealth’s networks. He also said, “It’s no secret that we are under substantial funding pressure from the federal government.”
According to a study by the Kaiser family Foundation, United received $540 million in bonus payments in 2012 — the largest share for any single carrier. United had a CMS rating of 3.17 stars that year, according to the study.
This is important as AARP endorses the popular AARP Medicare Advantage Insurance Plans, insured by UnitedHealthcare Insurance Company. According to WSJ article AARP issued a
statement saying it “has heard from a small number of our members regarding this decision” and was encouraging anyone with concerns to contact UnitedHealth directly.
The article points out “Medicare Advantage, an alternative to traditional Medicare, combines hospital and doctor coverage and often includes prescription drugs and perks like gym memberships. Enrollment has more than doubled since 2004 to 13 million in 2012, which represents about 27% of Americans on Medicare.” Also worth noting, “providers have the right to an appeal within 30 days.”
2014 Medicare Open Enrollment is here. Medicare Open Enrollment for 2014 ends Dec 7th. We, at Millennium Medical Solutions Inc, are working closely with affected members to help them find new providers and that patients enrolled in its commercial, Medicaid and Medicare supplement plans are not affected by the changes. Some members may turn back to original Medicare as a result of possibly losing their Doctors.
Download a Copy Of The Medicare and You 2014 Handbook Here.
Is your Doctor still in the network? Is Medicare Advantage still right for you? Please contact us for immediate review at (855) 667-4621. Please visit our https://360peo.com/about-us/blog to view past blogs and Legislative Alerts.