Company abandons traditional Medicare, leaving 6,900 Southern Nevadans in lurch

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Company abandons traditional Medicare, leaving 6,900 Southern Nevadans in lurch

A decision by Southwest Medical Associates to stop covering traditional Medicare patients — those who don’t have private add-on coverage to supplement their federal insurance — means nearly 7,000 seniors in Southern Nevada will have to find new doctors by Jan. 1.

Southwest currently serves 45,000 Medicare Advantage patients and 6,900 standard Medicare patients.

It has been one of only two major providers for Southern Nevada seniors with Medicare — the federal insurance program for those 65 and older — without supplemental coverage provided by private companies, such as a Medicare Advantage plan. With its withdrawal from the market, HealthCare Providers Nevada will be the only remaining large provider.

The change, which was not publicly announced, will impact seniors who don’t qualify for Medicaid, a federal program that provides coverage for low-income adults and others, but haven’t purchased the generally more-expensive add-on coverage.

‘Medicare Advantage plans are better’

Southwest, which manages a network of health care providers, released a statement late Friday afternoon saying that it was making the change to provide better care for its customers.

“Southwest Medical is making this change because Medicare Advantage plans are better for our patients, with better coordinated care and better health outcomes,” it said. “We’re working closely with our patients to help them through this transition.”

A study published in January by the National Bureau of Economic Research found that Medicare Advantage plans do offer higher quality than traditional Medicare, but also are more profitable for insurers.

James Stover, a public relations specialist working with Southwest, said officials with the company declined to respond to emailed questions from the Review-Journal about whether the decision would mean more profits for the company in the future.

Many primary care doctors in Las Vegas decline to take Medicare because they say reimbursement is less than private insurers and paperwork is more onerous.

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