This year, eight major U.S. health systems have canceled their Medicare Advantage contracts, often citing low reimbursement rates and prior authorization hassles.
The large-scale termination of these contracts could signal a national trend that could affect ASCs and health systems.
The following health systems are calling it quits with Medicare Advantage plans this year:
1. Two physician groups affiliated with San Diego-based Scripps Health filed termination notices with Medicare Advantage plans used by thousands of San Diego County patients, effective Jan. 1, 2024.
2. Mayo Clinic in Jacksonville, Fla., and Scottsdale, Ariz., warned patients that it plans to no longer accept most Medicare Advantage plans. If patients with those plans seek care, it will be considered out of network.
3. Corvallis, Ore.-based Samaritan Health Services ended its Medicare Advantage contracts with UnitedHealthcare, effective Jan. 9, 2024.
4. Cameron, Mo.-based Regional Medical Center terminated contracts with Cigna's Medicare Advantage plans in 2023 and plans to drop Aetna and Humana in 2024.
5. Stillwater (Okla.) Medical Center called it quits with in-network Medicare Advantage plans, blaming rising operating costs and a high prior authorization denial rate.
6. Starting in January, Brookings (S.D.) Health System will no longer be in network with Medicare Advantage plans.
7. Oregon-based St. Charles Health System is urging patients not to enroll in Medicare Advantage this year as it reevaluates its participation in contracts.
8. Louisville, Ky.-based Baptist Health Medical Group failed to agree with Humana's Medicare Advantage plans terms, alerting patients to seek other coverage options.