The expanding reach of Medicare Advantage is becoming an issue for small, rural hospitals, as providers reportedly face delays or non-payment.
Broad overview: According to hospital directors in rural areas, the growing enrollment in Medicare Advantage has put their finance at risk.
* Large and small hospitals report that Medicare Advantage insurers often delay or fail to pay.
Impact on rural hospitals: More than 150 rural hospitals have closed since 2010, as the private plans now cover over half of those eligible for Medicare and have increased fourfold in rural areas over the decade.
* Traditional Medicare compensates rural hospitals extra for low patient volumes under “critical access” designation, but Medicare Advantage plans often offer lower-negotiated rates.
* Battle Mountain General Hospital in remote Nevada refuses to contract Medicare Advantage plans due to their disbursements.
Case in point: Mesa View Regional Hospital in Nevada, which has 21 Medicare Advantage contracts, reports significant payment delays leaving them owed over $800,000 for care.
* Mesa View lost around $1.3 million taking care of patients.
Future Outlook: If current trends persist, around half of rural Medicare beneficiaries could be enrolled in Medicare Advantage plans within three years.
* Hospital operators want federal action to speed up care and ensure adequate compensation to keep rural hospitals viable.
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