(The Center Square) – Medicare Advantage is being cited as a reason for more hospital layoffs, and the practicing physician from North Carolina in Congress says it’s another warning shot.
“There is a day of reckoning coming for Medicare Advantage plans,” U.S. Rep. Dr. Greg Murphy wrote on X, the social media site formerly known as Twitter. “Started out with a good idea to save money, they have become a plan for denial of patient care, lack of payment to those who deliver the care and billions of $$ for insurance companies.”
Murphy is a urologist. His response was to a story out of Connecticut, where Bristol Health was saying it would lay off 21 and not hire for 39 vacancies due to lack of reimbursement from insurers.
According to Medicare.gov, Medicare benefits can come through original Medicare of a Medicare Advantage plan like a health maintenance organization or a preferred provider organization. These are colloquially called HMOs and PPOs.
“Medicare Advantage Plans, sometimes called ‘Part C’ or ‘MA Plans’,” the website says, “are offered by private companies approved by Medicare. Medicare pays these companies to cover your Medicare benefits.”
According to published reports, at least three North Carolina hospitals have exited the program since last summer. ECU Health in Greenville and WakeMed in Raleigh are no longer in network with Humana’s Medicare Advantage plans. Cape Fear Valley in Fayetteville has dropped United Healthcare Medicare Advantage.
The Government Accountability Office has reported Medicare issuing $47 billion in improper payments. A letter last Tuesday to Gene Dodaro, comptroller for the GAO, from Sens. Rick Scott R-Fla., Mike Braun, R-Ind., and J.D. Vance, R-Ohio, said other groups estimate Medicare fraud at about $60 billion annually.
