Centene, Humana, UnitedHealth Lead in Cutting Wasteful MA Services; Others Lag
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Nov 21, 2024
One of the biggest benefits of Medicare Advantage, according to its proponents, is its ability to reduce low-value care — the delivery of services that provide little or no clinical benefit — via its capitated payment model and the use of prior authorization. But a new study reveals that while some of the largest insurers are successfully cutting down on unnecessary services relative to traditional, fee-for-service Medicare, others are lagging behind, with rates of low-value care delivery similar to FFS Medicare.
The research, published this month in JAMA Network Open, shines a spotlight on how major players like UnitedHealthcare, Humana Inc. and Centene Corp. are leading the charge in reducing low-value services, while others like CVS Health Corp.’s Aetna, Elevance Health, Inc. and non-Elevance Blue Cross and Blue Shield plans still have room for improvement.
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