Medicare Advantage Membership Growth Slows Even As Insurers Jockey To Get A Piece Of Predictably Lucrative Field
Despite the slower pace, though, many Advantage insurers still experienced big enrollment increases as they picked up more market share. Other industry news looks at UnitedHealth's court loss over withholding payments to out-of-network physicians and Dr. Atul Gawande's decision to step out of a major health care conference.
Medicare Advantage Industry Sees Slower Growth For 2019
Medicare Advantage insurers added 1.4 million members to their rosters for 2019 coverage, as they looked to grow membership in a market known for being politically safe and predictably lucrative. But Advantage membership is growing at slower pace compared with previous years. According to the latest federal data showing enrollment as of this month, 22.4 million people are enrolled in Medicare Advantage for 2019 coverage—an alternative to the traditional Medicare program in which private insurers contract with the federal government to administer program benefits. (Livingston, 1/16)
UnitedHealth Loses Appeal Over Underpayments
A federal appeals court on Tuesday unanimously ruled against UnitedHealth Group over the insurer's policy of withholding payments to out-of-network physicians and hospitals in order to recover previous overpayments. The U.S. Eighth Circuit Court of Appeals upheld a Minnesota district court decision that sided with provider groups against the insurer, saying UnitedHealth overstepped administrative authority over its employer-sponsored health plans with a practice that recoups overpayments to a physician or hospital from one plan by cutting another plan's subsequent payments to the same provider. This is known as "cross-plan offsetting." (Luthi, 1/16)
Gawande Will No Longer Give Keynote At Major Health Conference
Since drawing tremendous attention when he was dispatched by the leaders of Amazon, JPMorgan Chase, and Berkshire Hathaway to create a venture with the long-term goal of transforming health care, [Atul] Gawande has virtually disappeared from the public eye. He isn’t giving interviews or releasing information about the direction of the new company. And now, Gawande has canceled a keynote at a major health care technology conference where leaders in the industry were hoping to get at least a whiff of what he is working on. A spokeswoman confirmed to STAT that he will not give a planned keynote speech next month at the HIMSS meeting in Orlando, because he decided it is better to keep a low profile during the early stages of his venture. (Ross, 1/17)