UnitedHealth Group has been eliminating physicians from its provider networks for Medicare Advantage plans across the nation to help control costs, and it is a trend that is set to continue.
Here are five things to know about the cuts:
1. UnitedHealth is the country's largest provider of privately managed Medicare Advantage plans, and the company has cut thousands of providers in its Medicare Advantage networks in states across the country, including Alabama, Connecticut, Florida, Georgia, Massachusetts, Missouri, North Carolina, Rhode Island and Tennessee.
2. In December 2013, UnitedHealth attributed its decision to narrow Medicare Advantage plan provider networks on "an era of Medicare Advantage funding cuts," according to a report from The Hill. For the entire 2013 fiscal year, UnitedHealth brought in $122.5 billion in revenue, up 10.7 percent from 2012, while earnings rose 1.8 percent to $5.63 billion. However, during the first quarter of 2014 the company's net earnings fell 7.8 percent, from approximately $1.2 billion in 2013 to $1.1 billion this year. UnitedHealth's financial growth was "offset by headwinds from new [PPACA] taxes and Medicare Advantage funding deficiencies," said Stephen J. Hemsley, president and CEO of UnitedHealth in a news release.
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4. In April, UnitedHealth cut almost 100 physicians from its Medicare Advantage network in
5. In July, legislation that would prevent Medicare Advantage plans from dropping providers in the middle of the year was introduced in Congress. Sens. Sherrod Brown (D-Ohio), Richard Blumenthal (D-Conn.) and Rep. Rosa DeLauro (D-Conn.) introduced the The Medicare Advantage Participant Bill of Rights Act, which would require Medicare Advantage plans to finalize their provider lists 60 days before the annual enrollment period.
Rep. DeLauro announced her intention to introduce the bill in April in response to UnitedHealth's move to cut thousands of providers from its Medicare Advantage networks at the end of 2013. "The timing and scale of UnitedHealth Group's provider cuts have been extremely disruptive to patient care and put participants at risk," said Rep. DeLauro, in a news release. "We have a responsibility to ensure Medicare Advantage plans are serving the needs of their participants." Sen. Blumenthal's decision to introduce the legislation was also partially prompted by UnitedHealthcare. "Our experience with UnitedHealthcare Group — unconscionably dropping hundreds of physicians — provides powerful evidence for this stronger protection," said Sen. Blumehthal in a news release.
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