Medicare Advantage network changes likely to impact 2014 patient mix

Why This Topic Matters

Payer network changes can alter which patients a practice sees and how those visits are covered, affecting scheduling, revenue, and overall payer mix. Understanding these trends helps practices prepare for coverage changes, evaluate participation decisions, and manage incoming patients under new plan structures.

Article Sections

1. Physician payments

   An overview of payer-network changes and their potential effect on practice revenue and patient flow. The section frames the market shifts that are influencing physician participation decisions.

2. 2 tips if you’re dropped

   General guidance for practices that are removed from a payer network, including administrative and patient communication considerations. The section addresses practice response planning in broad terms.

3. How to handle new patients

   Discussion of anticipated new patient sources, including changing coverage patterns and payer relationships. The section focuses on practice-level planning for incoming patients and payer mix management.

4. Exchange plans may be same as off-exchange

   A comparison of exchange and non-exchange insurance products and how they may appear similar to practices. The section highlights coverage-market overlap and the need for awareness when reviewing plan participation.