In the article “Dismantling Rural Access: MA Plans terminate rural healthcare providers, force patients to drive further for care, and then retain higher payments intended to support local access to healthcare,” Mike Thompson of the Louisiana Hospital Association examines how Medicare Advantage (MA) plans are disrupting healthcare access in rural areas.

Thompson in this recent Becker’s Hospital Review piece highlights that insurers are increasingly removing local providers from their networks, compelling rural seniors to travel greater distances for medical services. This practice not only severs longstanding doctor-patient relationships but also undermines the financial stability of Critical Access Hospitals (CAHs), which are vital to rural healthcare infrastructure.

As CrossTx is a major provider of Chronic Care Management (CCM) and related services to critical access hospitals with clinics, clearly this article points to a troubling potential reality. 

Like that traditional Medicare offers enhanced reimbursements to support these low-volume hospitals, yet MA plans often retain these higher payments without passing them on to the local providers, thereby profiting at the expense of rural healthcare access.

Thompson in his piece also notes that recent policy changes have weakened protections that previously ensured MA enrollees had adequate access to local care. The reduction in network adequacy standards has exacerbated access issues, leading to increased patient dissatisfaction and prompting some to revert to traditional Medicare. The article calls for policy reforms to address these challenges, including revisiting MA network adequacy standards, ensuring payment parity for CAHs, and creating new voluntary payment models to sustain rural healthcare providers.

For rural hospitals and clinics, this analysis underscores the pressing need to advocate for policy changes that protect local healthcare access and ensure fair reimbursement practices. Engaging with policymakers to strengthen network adequacy standards and seeking innovative payment models could be crucial steps toward preserving the viability of rural healthcare services.