Dive Brief:
UnitedHealthcare announced Wednesday it will accelerate Medicare Advantage payments to rural hospitals in four states as part of a pilot program to alleviate financial strain on struggling facilities.
The insurer says it will cut its MA payment timelines in half, from 30 days to 15 days on average. Rural providers in Oklahoma, Idaho, Minnesota and Missouri will participate in the six-month pilot.
A spokesperson for UnitedHealth declined to name the hospitals participating in the pilot program, but said participants were chosen from states with rural communities and independent hospitals that could “benefit quickly” from the program.
Dive Insight:
Providers have long complained that insurers in MA reimburse below cost and delay medically necessary care, negatively impacting patients and adding to already heavy administrative red tape. Meanwhile, insurers contend they need to keep a handle on rising medical costs.
Payer and provider squabbling over rate adjustments and utilization management in MA has led to a spike in contract disputes for MA plans.
Rural providers in particular say they experience disproportionate financial losses in MA. MA plans typically pay rural providers 90% of what traditional Medicare pays for the same services, and more than 80% of physicians say insurer requirements like prior authorizations negatively impact care, according to a report from the American Hospital Association published early 2025.
Tensions have only intensified as MA plans grow and capture a higher share of Medicare enrollees, attracted by low- to no-premium plans and perks like free gym memberships. Over half of all Medicare-eligible beneficiaries were enrolled in MA plans last year, with rural hospitals seeing the fastest growth in MA patients, according to the AHA.
At the same time, rural hospitals have been struggling to navigate a tough operating landscape, workforce shortages and looming cuts to federal programs. More than 100 hospitals have closed in the past decade, and one-third of all rural hospitals in the country are at risk of closure due to serious financial problems, according to the Center for Healthcare Quality and Payment Reform.
UnitedHealthcare said the accelerated payments would help support care at “critical” rural facilities.
“Our goal is to co-create solutions with rural providers that support accessible care close to home,” Bobby Hunter, CEO of UnitedHealthcare’s government programs division, said in a statement.
UnitedHealthcare is the largest MA insurer, covering some 8 million seniors in the privatized Medicare program. Over the past year, the company has worked to overhaul its business practices to improve consumer trust and head off regulatory and legislative scrutiny — in part over concerns over its MA division.
Wednesday’s announcement of the rural health pilot follows a pledge from the insurer to pare back its prior authorization burden on providers and hold itself to a higher standard in areas like MA billing.
Still, the announcement of the rural health pilot comes days after Sen. Chuck Grassley, R-Iowa, accused UnitedHealthcare’s owner UnitedHealth of inflating the sickness of its members in the MA program to receive higher reimbursement from the government.
The report, based on records that UnitedHealth shared with the senator’s office, found UnitedHealth oversees a workforce dedicated to MA upcoding, including through its relationships with providers.
A UnitedHealth spokesperson said the company disagreed with the report’s findings.
