I do believe HC is essentially in trouble. With 2027 projected MA revenue change of 0.09% which indirectly affects 2026 projections, projected further MA membership attrition (up to 3 million), HC will inevitably shrink.
“They’re choosing profitability over membership in certain books (expecting membership attrition as they reprice / exit margin-dilutive segments).” Basically dropping millions of members where they’re supposedly losing money. It doesn’t look good at all.
@dx nothing
Has anyone heard anything from their managers?
@cy I understand what you’re saying, but clinician must exercise professional judgment when documenting let alone diagnosing during a visit. Keep it simple, review meds, and history with a patient. Document what’s supported or reported. Done.
They are in trouble cause you can’t send a nurse practitioner’s to someone’s house so you can get info to try to beef up your risk adjustment scores.
Is anyone’s else’s schedule back to only
Being full for about two weeks with a few random days scheduled beyond that?
Thinking the same thing. Loss of members, loss of reimbursement, loss of funds. Expensive APCs. The big question is how much will be cut and when.
Cms and Congress are really scrutinizing coding only visits right now. HC (and PSU for Wellmed TX) are probably in trouble.