Seeing the Bigger Picture: How Payers and Providers Can Find Common Ground in Medicare Advantage

A growing number of disputes have arisen between health systems and Medicare Advantage (MA) plans, with 15 health systems finalizing terminations so far this year. Some have resulted in terminating a single plan’s MA contract, while others have terminated the entire portfolio of MA contracts.

Conflicts between payers and providers are not new. But the volume of these particular conflicts is telling. We believe it is a confluence of compounding pressures that both health systems and health plans are facing.

In this joint article with our colleagues at Chartis, we discuss what’s at the core of these MA disputes and four ways health plans and health systems can find common ground to create a more amicable and mutually beneficial outcome for the health plan, health system, and the patients/members.

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HealthScape Can Help

The current approach to MA contracting is unsustainable. Our team has extensive experience supporting health plans in payer-provider relations and MA strategy. And now as part of Chartis, we have deeper and expanded capabilities to help both payers and providers manage transformational change in a rapidly evolving healthcare ecosystem that is increasingly defined by payer-provider convergence.