Bryan Johnson, MD, an internal medicine physician in Frisco, Texas, has tried hard over the past 3 years to drop all of his practice's Medicare Advantage (MA) contracts, dropping the percentage of MA patients from 30% or 40% of his practice to 5%.
As the percentage of Medicare beneficiaries enrolled in MA plans has mushroomed -- from 24% in 2010 to 54% in 2026 -- why is Johnson's practice bucking the trend?
Because treating patients enrolled in MA plans costs a lot more than what the plans pay the two doctors and a PA in his practice, Johnson told MedPage Today. He also dislikes the tactics plans use to transfer beneficiaries out of fee-for-service Medicare.
"They are just horrible plans, in my opinion," he said. "We try to avoid them as much as possible because of our experience with them over the years."
For starters, some of the plans have been automatically downcoding a level 4 or 5 visit to a level 3, meaning that the amount his practice receives will be as much as 25% of the claim submitted. "I'd spend time with the patient, coordinate their care, we do a follow-up, get them to a subspecialist if necessary. All that work and they automatically downcode it," he said. "It's a significant amount of lost revenue."
