Most CFOs say collecting from Medicare Advantage is getting harder

Ninety-two percent of health system CFOs surveyed said that collecting from Medicare Advantage plans is more difficult than it was two years ago, according to a report from the Healthcare Financial Management Association and Eliciting Insights. 

"HFMA Health System CFO Pain Points 2024" is based on a survey of 135 health system CFOs conducted in January, according to the report. 

The report found that 62% of CFOs believe collecting from Medicare Advantage is "significantly more difficult" than it was two years ago, and another 30% said they believe it is "somewhat more difficult." Only 8 % said they believe there has been no change. 

According to the CFOs surveyed, the top challenges with Medicare Advantage plans are: 

  • Onerous prior authorization requirements: 87%
  • Denials for medical records: 75%
  • Changing clinical policies to reduce services they have to cover: 69%
  • Low reimbursement relative to traditional Medicare: 52%

 The report also found that 16% of health systems are planning to stop accepting one or more Medicare Advantage plans in the next two years. Another 45% said they are considering the same but have not made a final decision. 

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