There have been a lot of changes to Medicare Advantage plans of late--UnitedHealth dropped providers in Alabama, Humana lost a big provider contract and MVP Health Care is discontinuing two of its plans.
UnitedHealth is dropping more doctors from its Medicare Advantage network; this time the insurer is focusing on the Alabama market. Although the insurer won't disclose how many providers it's cutting, spokeswoman Sarah Bearce told the Birmingham News that it expects its networks to be about 85 percent to 90 percent of their original size by the end of the year.
That means UnitedHealth will have about 1,100 primary care doctors and 3,100 specialists in its Alabama Medicare Advantage network next year. But Dennis O'Brien, president of the east region of UnitedHealthcare Medicare & Retirement, told the Birmingham News that he doesn't consider the restructuring to fall into the narrow network category. Instead, he says, UnitedHealth is building "more focused networks."
These focused networks mean UnitedHealth will be in a tighter, more collaborative relationship with its providers. "Those [doctors] who only had a handful of members don't understand all the tools and technology that we brought to the table," O'Brien added.
Meanwhile, CentraCare Health System, the sixth-largest provider in Minnesota, said it will stop contracting with Humana's Medicare Advantage plan effective Jan. 1. CentraCare is primarily discontinuing its relationship because of allegations brought by Minnesota Attorney General Lori Swanson that Humana overcharged or inappropriately denied claims for its Medicare Advantage members in Minnesota, the Minneapolis/St. Paul Business Journal reported.
And in New York, MVP Health Care announced that it's discontinuing two of its five Medicare Advantage plans. Its three remaining plans will include higher co-payments and premiums, the Democrat & Chronicle reported. Almost 20,000 people will be impacted by the changes, which MVP Health Care said were driven by federal cuts to the Medicare Advantage program.
To learn more:
- see the Birmingham News article
- read the Minneapolis/St. Paul Business Journal article
- check out the Democrat & Chronicle article