Two Scripps Health medical groups have canceled their Medicare Advantage contracts for 2024 because of reported losses exceeding $75 million, according to health media reports.
Medpage Today said the contracts with Scripps Coastal and Scripps Clinic involving some 30,000 seniors were canceled because of low reimbursement and problems with prior authorization.
Medicare Advantage plans, known as Part C under Medicare, bundle basic Medicare with coverage for doctors visits, dentists, vision and usually prescriptions. About half of Medicare-eligible patients have a Medicare Advantage plan, which is an alternative to basic Medicare plus optional supplemental insurance.
Scripps CEO Chris Van Gorder told Medpage Today that negotiations to resolve the cost issues were unsuccessful. He said affected patients can switch to other Scripps medical groups, or enroll in other types of medical insurance.
“We certainly regret any inconvenience to them,” he said, but “that kind and size of loss is unsustainable by Scripps.”
Five other Scripps groups will continue to take Medicare Advantage plans.