Medicare Advantage is growing fast, and that’s bad for rural hospitals : Shots

Since 2010, 150 rural hospitals have closed in the United States. Hospital leaders say that Medicare Advantage pays slowly and sometimes not at all and that this could push more hospitals to the brink.

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Jason Bleak runs Battle Mountain General Hospital, a small facility in a remote Nevada gold-mining town that he describes as “out here in the middle of nowhere.”

When several representatives from private health insurance companies called on him a few years ago to offer Medicare Advantage plan contracts so their enrollees could use his hospital, Bleak sent them away.

“Come back to the table with a better offer,” the chief executive recalls telling them. The representatives haven’t returned.

Battle Mountain is in north-central Nevada, about a three-hour drive from Reno and four hours from Salt Lake City. Bleak (whose name is pronounced “Blake”) suspects insurance companies simply haven’t enrolled enough of the area’s seniors to need his hospital in their network.

Medicare Advantage insurers are private companies that contract with the federal government to provide Medicare benefits to seniors in place of traditional Medicare. The plans have become dubious payers for many large and small hospitals, which report that the insurers are often slow to pay or don’t pay.

Private plans now cover more than half of those eligible for Medicare. And while enrollment is highest in metropolitan areas, it has increased fourfold in rural areas since 2010. Meanwhile, more than 150 rural hospitals have closed since 2010, according to the Cecil G. Sheps Center for Health Services Research at the University of North Carolina. States such as Texas, Tennessee and Georgia have had the…