Understanding the Medicare Advantage Exodus
A significant shift Hospitals is reshaping the American healthcare landscape as 29 health systems across the United States have severed ties with Medicare Advantage plans throughout 2024 and 2025. This unprecedented wave of contract terminations signals growing tensions between healthcare providers and insurance companies, leaving millions of Medicare beneficiaries facing potential disruptions in their coverage and access to care.
Medicare Advantage plans, also known as Medicare Part C, are private insurance alternatives to traditional Medicare that have grown exponentially over the past decade. However, the relationship between hospitals and these insurers has deteriorated dramatically, forcing healthcare systems to make difficult decisions about network participation.
Why Are Hospitals Dropping Medicare Advantage Plans?
Primary Authorization Challenges
Healthcare providers cite excessive prior authorization denial rates as the leading factor driving their decisions to exit Medicare Advantage networks. Prior authorization requires providers to obtain approval from insurers before delivering specific treatments, procedures, or medications. When denial rates climb too high, hospitals face significant administrative burdens and delayed patient care.
Payment Processing Issues
Slow payments from insurers represent the second major concern plaguing provider-payer relationships. Healthcare systems report increasingly lengthy reimbursement cycles that strain operational budgets and cash flow management. These payment delays can extend for months, creating financial hardships for hospitals already operating on thin margins.
Administrative Burden
Beyond authorization denials and payment delays, healthcare providers struggle with mounting administrative costs associated with Medicare Advantage plans. The complexity of managing multiple plan requirements, documentation standards, and billing procedures diverts resources from direct patient care.
Complete List of Health Systems Ending Medicare Advantage Contracts
Major Metropolitan Health Systems
Johns Hopkins Medicine (Baltimore, Md.) made headlines by exiting UnitedHealthcare Medicare Advantage networks in August 2024. This prestigious academic medical center’s decision underscores the severity of provider-payer conflicts.
Vanderbilt Health (Nashville, Tenn.) terminated its agreement with BCBS Tennessee Medicare Advantage, affecting thousands of beneficiaries in the region.
Baylor Scott & White (Dallas, Texas) ended its Humana Medicare Advantage network participation effective January 1, 2025, representing one of the largest health systems in Texas.
The Ohio State University Wexner Medical Center (Columbus, Ohio) went out of network with Anthem Medicare Advantage starting January 1, 2025.
Regional Healthcare Networks
Memorial Healthcare System (Hollywood, Fla.) discontinued Florida Blue Medicare Advantage contracts in September 2024.
MUSC Health (Charleston, S.C.) allowed its Humana Medicare Advantage contract to expire on June 30, 2024.
Providence-based Brown University Health and UnitedHealthcare Medicare Advantage mutually agreed to separate on July 1, 2024.
Salem Health (Oregon) and Regence BCBS Medicare Advantage parted ways in February 2024.
North Mississippi Health Services (Tupelo, Miss.) exited UnitedHealthcare Medicare Advantage on June 1, 2024.
Midwestern Healthcare Providers
Iowa Specialty Hospitals and Clinics (Clarion, Iowa) announced plans to drop nearly all Medicare Advantage plans in 2026, maintaining only Aetna, Medigold, UnitedHealthcare, and Wellmark BCBS.
Trinity Health Michigan (Livonia, Mich.) left Humana’s network effective January 1, 2025.
MercyOne (West Des Moines, Iowa) terminated Humana Medicare Advantage participation beginning January 1, 2025.
North Memorial Health (Robbinsdale, Minn.) ended Humana contracts entirely.
Essentia Health (Duluth, Minn.) exited Humana Medicare Advantage networks throughout 2025.
Allina Health (Minneapolis, Minn.) discontinued Humana Medicare Advantage participation in 2025.
Avera Health (Sioux Falls, S.D.) and Sanford Health (Sioux Falls, S.D.) both terminated Humana relationships effective January 1, 2025.
Prairie Lakes Healthcare System (Watertown, S.D.) dropped Humana Medicare Advantage in January 2025.
Additional Healthcare Systems Exiting Medicare Advantage
- Bayhealth (Dover, Del.) – Terminated Humana and Cigna contracts January 1, 2025
- WakeMed (Raleigh, N.C.) – Out of network with Humana for non-state retirees
- CommonSpirit hospitals (Colorado) – Separated from Humana January 1, 2025
- WVU Medicine’s Uniontown Hospital (Pa.) – Left Highmark networks January 1, 2025
- Blessing Health (Quincy, Ill.) – Limited contracts to four insurers only
- LMH Health (Lawrence, Kan.) – Dropped Aetna and Humana effective January 1, 2025
- Great Plains Health (North Platte, Neb.) – Ended all Medicare Advantage participation in 2025
- Kimball Health Services (Neb.) – Stopped accepting all Medicare Advantage plans in 2025
- Carson Tahoe Health (Carson City, Nev.) – Accepts only Prominence and Senior Care Plus
- Southwestern Health Resources (Farmers Branch, Texas) – Exited Aetna Medicare Advantage in 2025
- MyMichigan Health (Midland, Mich.) – Left Aetna network in 2025
Impact on Patients and Healthcare Access
Medicare Advantage beneficiaries face significant challenges when their preferred healthcare providers exit plan networks. Patients must either switch to different Medicare Advantage plans that include their doctors and hospitals, transition to traditional Medicare, or accept out-of-network costs that can be substantially higher.
These network disruptions disproportionately affect seniors and individuals with disabilities who have established long-term relationships with their healthcare providers. The upheaval forces vulnerable populations to navigate complex insurance decisions during critical periods.
What This Means for the Future
The ongoing exodus from Medicare Advantage networks represents a crisis point in American healthcare. Unless insurers and providers reach sustainable agreements addressing authorization processes and payment timelines, more health systems will likely follow suit. This trend threatens the viability of Medicare Advantage as a coverage option and signals the need for significant policy reforms.
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