Medicare Advantage provides health coverage to more than half of the nation's older adults, but some hospitals and health systems are opting to end contracts with MA plans over administrative challenges.
Among the most commonly cited reasons are excessive prior authorization denial rates and slow payments from insurers.
In 2023, Becker's began reporting on hospitals and health systems nationwide that dropped some or all of their Medicare Advantage contracts.
Data on this topic is limited. In January, the Healthcare Financial Management Association and Eliciting Insights released a survey of 135 health system CFOs, which found that 16% of systems are planning to stop accepting one or more MA plans in the next two years. Another 45% said they are considering the same but have not made a final decision. The report also found that 62% of CFOs believe collecting from MA is "significantly more difficult" than it was two years ago.
32 health systems dropping Medicare Advantage plans:
Editor's note: This is not an exhaustive list. It will continue to be updated this year
- The Ohio State University Wexner Medical Center in Columbus will be out of network with Anthem Medicare Advantage in 2025.
- Huntsville (Ala.) Hospital Health System will be out of network with UnitedHealthcare Medicare Advantage system-wide in 2025. Individual hospitals within the system began leaving the network Oct. 15.
- WVU Medicine's Uniontown (Pa.) Hospital and its affiliated provider groups will no longer be participating providers with Highmark PA or Highmark Wholecare Medicare Advantage in 2025.
- Robbinsdale, Minn.-based North Memorial Health is ending its contract with Humana Medicare Advantage, effective Dec. 31, 2024.
- Duluth, Minn.-based Essentia Health will be out-of-network with Humana Medicare Advantage plans in 2025.
- Watertown, S.D.-based Prairie Lakes Healthcare System will drop Humana Medicare Advantage in 2025.
- North Kansas City (Mo.) Hospital and Meritas Health will no longer be in-network with Aetna Medicare Advantage plans, effective Oct. 1, 2024.
- Nashville-based Vanderbilt Health will no longer be in network with BCBS Tennessee Medicare Advantage, effective in 2025.
- Sioux Falls, S.D.-based Avera Health will end participation as an in-network provider with Humana Medicare Advantage on Dec. 31, 2024.
- Quincy, Ill.-based Blessing Health is implementing a new MA approach in 2025 and will only contract with BCBS, UnitedHealthcare, Molina and Total Retiree Advantage Illinois.
- Lawrence, Kan.-based LMH Health will no longer accept Aetna or Humana Medicare Advantage, effective Jan. 1.
- Brewer, Maine-based Northern Light Health is ending its Medicare Advantage contract with Humana, effective Sept. 30.
- Sioux Falls, S.D.-based Sanford Health is dropping Humana Medicare Advantage in Minnesota in 2025.
- North Platte, Neb.-based Great Plains Health will no longer accept any Medicare Advantage plans in 2025.
- Kimball (Neb.) Health Services will no longer accept any Medicare Advantage plans starting in 2025.
- Carson City, Nev.-based Carson Tahoe Health will no longer be in network with UnitedHealthcare Medicare Advantage by May 30, 2025.
- Midland-based MyMichigan Health will no longer participate in the Aetna Medicare Advantage Network at all facilities after Dec. 31.
- Canton, Ohio-based Aultman Health System's hospitals will no longer be in network with Humana Medicare Advantage after July 1, and its physicians will no longer be in network after Aug. 1.
- Albany (N.Y.) Med Health System stopped accepting Humana Medicare Advantage on July 1.
- Munster, Ind.-based Powers Health (formerly Community Healthcare System) went out of network with Humana and Aetna's Medicare Advantage plans on June 1.
- Lawton, Okla.-based Comanche County Memorial Hospital stopped accepting UnitedHealthcare Medicare Advantage plans on May 1.
- Houston-based Memorial Hermann Health System stopped contracting with Humana Medicare Advantage on Jan. 1.
- York, Pa.-based WellSpan Health stopped accepting Humana Medicare Advantage and UnitedHealthcare Medicare Advantage plans on Jan. 1. UnitedHealthcare D-SNP plans in some locations are still accepted.
- Newark, Del.-based ChristianaCare is out of network with Humana's Medicare Advantage plans as of Jan. 1, with the exception of home health services.
- Greenville, N.C.-based ECU Health stopped accepting Humana's Medicare Advantage plans in January.
- Zanesville, Ohio-based Genesis Healthcare System dropped Anthem BCBS and Humana Medicare Advantage plans in January.
- Corvallis, Ore.-based Samaritan Health Services' hospitals went out of network with UnitedHealthcare's Medicare Advantage plans on Jan. 9. Samaritan's physicians and provider services will be out of network on Nov. 1.
- Cameron (Mo.) Regional Medical Center stopped accepting Aetna and Humana Medicare Advantage in 2024.
- Bend, Ore.-based St. Charles Health System stopped accepting Humana Medicare Advantage on Jan. 1 and Centene MA on Feb. 1.
- Brookings (S.D.) Health System stopped accepting all Medicare Advantage plans in 2024.
- Louisville, Ky.-based Baptist Health went out of network with UnitedHealthcare Medicare Advantage and Centene's WellCare on Jan. 1.
- San Diego-based Scripps Health ended all Medicare Advantage contracts for its integrated medical groups, effective Jan. 1.