Medicare Advantage (MA) provides health coverage to more than half of the nation's older adults, but some hospitals and health systems are opting to end their contracts with MA plans over administrative challenges.
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 their 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.
In January, the Healthcare Financial Management Association 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.
Fifteen health systems dropping Medicare Advantage plans in 2024:
Editor's note: This is not an exhaustive list. It will continue to be updated this year. Here is the latest as of July 24, 2024.
1. Canton, Ohio-based Aultman Health System's hospitals stopped being in network with Humana Medicare Advantage July 1, and its physicians will no longer be in network after Aug. 1.
2. Albany (N.Y.) Med Health System stopped accepting Humana Medicare Advantage on July 1.
3. Munster, Indiana-based Powers Health (formerly Community Healthcare System) went out of network with Humana and Aetna's Medicare Advantage plans on June 1.
4. Lawton, Oklahoma-based Comanche County Memorial Hospital stopped accepting UnitedHealthcare Medicare Advantage plans on May 1.
5. Houston-based Memorial Hermann Health System stopped contracting with Humana Medicare Advantage on Jan. 1.
6. York, Pennsylvania-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.
7. Newark, Delaware-based ChristianaCare is out of network with Humana's Medicare Advantage plans as of Jan. 1, with the exception of home health services.
8. Greenville, N.C.-based ECU Health stopped accepting Humana's Medicare Advantage plans in January.
9. Zanesville, Ohio-based Genesis Healthcare System dropped Anthem BCBS and Humana Medicare Advantage plans in January.
10. Corvallis, Oregon-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.
11. Cameron (Mo.) Regional Medical Center stopped accepting Aetna and Humana Medicare Advantage in 2024.
12. Bend, Oregon-based St. Charles Health System stopped accepting Humana Medicare Advantage on Jan. 1 and Centene MA on Feb. 1.
13. Brookings (S.D.) Health System stopped accepting all Medicare Advantage plans in 2024.
14. Louisville, Kentucky-based Baptist Health went out of network with UnitedHealthcare Medicare Advantage and Centene's WellCare on Jan. 1.
15. San Diego-based Scripps Health ended all Medicare Advantage contracts for its integrated medical groups, effective Jan. 1.
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