When Congress passed legislation allowing corporate health insurers to offer Medicare benefits, our representatives may not have appreciated that the new law would effectively be increasing shareholder value for the biggest health insurers and putting millions of vulnerable older adults and people with disabilities at risk of not getting needed care. They likely did not imagine that Medicare Advantage insurers would inappropriately underpay hospitals, nursing homes, home health agencies and rehabilitation facilities, harming them financially or, worse still, forcing them to close their doors. Jakob Emerson reports for Beckers on how 24 health systems across the country are dropping their Medicare Advantage contracts because they are not able to deliver Medicare Advantage enrollees the care they need and because insurers are not paying them appropriately.
In all likelihood, the corporate health insurers offering Medicare Advantage likely did not start off engaging in the bad acts many of them currently engage in, including using prior authorization processes excessively, delaying and denying care inappropriately, and failing to pay physicians and hospitals adequately. Nor were they overcharging the government excessively at the outset. But, today, more than six in ten provider CFOs say that the obstacles to care and payment are only getting worse.
Beckers now lists 24 health systems that are ending their Medicare Advantage contracts, some with all Medicare Advantage insurers. Other health systems are cancelling contracts with UnitedHealthcare and/or Humana, two of the largest Medicare Advantage insurers. The list is not comprehensive. So, if you’re in a Medicare Advantage plan now, check to see whether you will be able to continue to use the doctors and hospitals you want to use or whether they are no longer in the provider network.
In California, Scripps Health ended all its Medicare Advantage contracts for its integrated medical groups this year.
In Delaware, ChristianaCare cancelled its contract with Humana’s Medicare Advantage plans as of Jan. 1.
In Illinois, Blessing Health is only continuing its contracts with BCBS, UnitedHealthcare, Molina and Total Retiree Advantage.
In Indiana, Powers Health (formerly Community Healthcare System) cancelled their contracts with Humana and Aetna’s Medicare Advantage plans on June 1.
In Kansas, LMH Health is cancelling contracts with Aetna and Humana Medicare Advantage in 2025.
In Kentucky, Baptist Health cancelled its contract with UnitedHealthcare Medicare Advantage and Centene’s WellCare this year.
In Maine, Northern Light Health is cancelling its Medicare Advantage contract with Humana beginning October 1.
In Michigan, MyMichigan Health is cancelling its Aetna Medicare Advantage contract in 2025.
In Minnesota, HealthPartners is cancelling its contract with UnitedHealthcare Medicare Advantage plans in 2025. Essentia Health is cancelling its contracts with UnitedHealthcare and Humana Medicare Advantage in 2025.
In Missouri, Cameron (Mo.) Regional Medical Center cancelled its Aetna and Humana Medicare Advantage contracts this year.
In Nebraska, Kimball (Neb.) Health Services is cancelling all its Medicare Advantage contracts in 2025.
In Nevada, Carson Tahoe Health is cancelling its contract with UnitedHealthcare Medicare Advantage in 2025.
In New York, Med Health System cancelled its contract with Humana Medicare Advantage on July 1.
In North Carolina, ECU Health cancelled its Humana’s Medicare Advantage plans in January.
In Ohio, Aultman Health System hospitals are cancelling their contracts with Humana Medicare Advantage in 2025. Genesis Healthcare System cancelled contracts with Anthem BCBS and Humana Medicare Advantage plans in January.
In Oklahoma, Comanche County Memorial Hospital cancelled its contract with UnitedHealthcare Medicare Advantage plans on May 1.
In Oregon, Samaritan Health Services‘ hospitals cancelled its contracts with UnitedHealthcare’s Medicare Advantage plans on Jan. 9. They are cancelling contracts for physicians and provider services on Nov. 1. St. Charles Health System cancelled its contracts with Humana Medicare Advantage and Centene MA.
In Pennsylvania, WellSpan Health ended its Humana Medicare Advantage and UnitedHealthcare Medicare Advantage plans on Jan. 1. It still accepts some UnitedHealthcare D-SNP plans.
In South Dakota, Sanford Health is cancelling its Humana Medicare Advantage in Minnesota in 2025. Brookings (S.D.) Health System cancelled all its Medicare Advantage contracts this year.
In Texas, Memorial Hermann Health System ended its contract with Humana Medicare Advantage on Jan. 1.
Here’s more from Just Care:
- Project 2025 would push everyone with Medicare into Medicare Advantage
- Medicare Advantage plans continue to endanger hospitals and patients
- 2024: Too little known about Medicare Advantage
- Home visits: Another way Medicare Advantage plans gouge taxpayers
- Low-income communities are particularly at risk in Medicare Advantage
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