Hospitals Encouraged to Review Medicare Advantage Enrollment Plans

Medicare Advantage (MA) enrollment in Michigan totaled approximately 1.2 million in July, an increase of 15,000 beneficiaries since April. The July MA enrollment is spread across 47 MA plans that are currently operating in the state, with approximately 56% of Michigan’s 2.1 million Medicare beneficiaries covered by an MA plan.

Hospitals are encouraged to carefully review payments from each MA plan to ensure that the plan has paid the correct rates. With up to 30 plans covering beneficiaries in some Michigan counties, a significant burden has been created for hospitals, which may be intensified if MA plans conduct their own audits for medical necessity and other utilization issues.

To assist hospitals in identifying which MA plans are currently operating in their region, the MHA has updated the list of plans in each Michigan county based on July enrollment. In addition to the 47 plans currently licensed in the state, Michigan hospitals often treat patients covered by MA plans licensed in other states, further complicating the payment process. Members with questions should contact Katie Jaskolski at the MHA.