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Private Medicare just isn’t the gold mine it once was. Case in point: Cano Health, a company once valued at $4.4 billion, is now bankrupt.

The prospect of bankruptcy had stalked the Miami-based primary care provider for well over a year before its Chapter 11 filing on Sunday. A number of things had gone wrong. First, there was Cano’s rapid growth ahead of its 2021 initial public offering that gave way to a mountain of debt, currently sitting at $1.3 billion. Then there was public beef between its former directors and then-CEO.

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Most importantly, the company’s main business, Medicare Advantage, became less profitable. As evidence accumulated that the private insurers running MA plans game the system by exaggerating their members’ illnesses, the Biden administration vowed to fix the problem. This year, Medicare is phasing in a new payment model designed to reduce overpayment.

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