Signaling what may be an emerging national trend, two influential medical groups with San Diego-based Scripps Health are cancelling their Medicare Advantage contracts for 2024 because of low reimbursement and prior authorization hassles, leaving 30,000 enrolled seniors to look for new doctors, or different coverage.
“Negotiations with the payers for MA with our medical foundation groups and Scripps Health were unsuccessful and we have been forced to withdraw from those plans due to annual losses that exceeded $75 million,” Scripps CEO Chris Van Gorder told MedPage Today in an early morning email.
He said the losses are due to “low reimbursement, denials, and administrative costs to manage high utilization and out of network care.”
Van Gorder emphasized that about 30,000 enrollees will have to make a change in their coverage or pick another doctor. About 1,000 physicians and advanced practitioners such as physician assistants are members of the two groups.
Sounds like to do the gig as they intend you'd have to be strung out. Wild story, thanks for sharing!