It Ain’t Over ‘Til its Covered – Medicare Advantage and COVID-19

Yogi Berra is famous for saying quotes that sometimes we didn’t understand. And one of the things that he said was: If you see a fork in the road, take it.

Now. I’m not sure what that means.

I don’t even know if he knew what that meant, but I think I’m going to take his advice anyway.

I’m stuck at a fork.

On the one hand, it seems like Medicare advantage plans were really looking to help their membership throughout the COVID crisis, with whatever they can do. They were offering transportation, they were offering food, they were waving a lot of out of pocket costs. They were trying to keep in touch with membership throughout the crisis to see if they can help them with anything that they can. And it really shows the value that a Medicare advantage plan can really offer in the healthcare market.

On the other hand, some people are looking at this and saying: One second, Medicare advantage plans were really doing well during this crisis. There was very low hospitalizations — aside for COVID related hospitalizations. People were avoiding any elective surgery or doctor visits at all costs. So insurance companies are in the business of getting paid and only paying out when there’s a claim for them to pay for care that was provided. They were really doing well. They were cashing in, but not having to pay out too much. So that is the opinion of some people.

Therefore we’re stuck at a fork, which way do we go? And we’re going to take it.

I’m going to tell you how we can figure this out by ourselves. And that is, let’s give it some time. Because as hopefully COVID will be further and further in the rear view mirror, let’s hope. what’s going to happen is that we can watch and see: Will the Medicare advantage plans continue to offer similar benefits and advantages to their membership even as the hospitalizations are on an uptick or perhaps the claims are coming in more regularly? Will they still continue to add these kinds of benefits? If they do, we know what their motivation was throughout.

So I think we can just give this some time. and we’ll see exactly how the insurance companies will treat their membership for the long haul.

And as Yogi famously says, you can observe a lot by watching.

Let’s watch and see what happens.

And thank you so much for watching this. Let me know what you think in the comments.

Steve Shain is the Chief Operating Officer of LTC Contracting.

LTC Contracting guides providers through licensure and business setup procedures and ensures compliance with all regulations, whether the providers are opening new organizations or adding new service lines to their existing businesses. LTC’s services also include getting providers credentialed and on the Managed Care Organizations’ (MCOs’) networks.

Founded in 2006, LTC Ally serves the long-term care industry with an unbound dedication to improving back office and financial operations. With a mission to reduce burdens and increase peace of mind, LTC Ally set out to revolutionize the way facilities handle their revenue cycle management. With a full suite of financial, case management, and contracting solutions for healthcare providers, LTC Ally is your partner in long-term care and skilled nursing.

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