The 'unique implications' of Medicare Advantage for rural hospitals

The rising enrollment in Medicare Advantage plans has "unique implications" for rural hospitals, according to a Feb. 13 report from the the Chartis Center for Rural Health. 

Four things to know:

1. MA enrollment in rural communities has increased 48% between 2019 and 2023, according to the report.

2. Because MA does not follow cost-based reimbursement, MA net reimbursement to critical access hospitals is often lower than traditional Medicare for similar services, the report said.

3. Rural providers "may not be equipped to efficiently navigate administrative requirements for payment introduced by Medicare Advantage, such as prior authorizations." This can lead to increased denials, Chartis said.

4. Public data reporting differences for MA and traditional Medicare claims can hamper rural hospitals' ability to fully understand their populations' healthcare experience and needs, according to the report. 

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