Two Michigan Health Systems Drop Medicare Advantage Plans

Becker's finds that 20 health systems nationwide dropped some Medicare Advantage plans.  Mostly, this reflects excessive prior authorization denial rates and slow payments from insurers.  Trinity Health was at odds with both Aetna or Humana Medicare advantage plans, but did finally reach agreement with Aetna (a CVS subsidiary with its own financial problems).  Conversely, MyMichigan Health dropped the Aetna Medicare Advantage plans:

https://www.beckershospitalreview.com/finance/20-health-systems-dropping-medicare-advantage-plans-2025.html

20 health systems dropping Medicare Advantage plans in 2025
Jakob Emerson - Thursday, January 2nd, 2025

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 or not renew contracts with some 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. 2024 coverage is here.

20 health systems dropping Medicare Advantage plans:
Editor's note: This is not an exhaustive list. It will continue to be updated this year.

Dallas-based Baylor Scott & White is no longer in network with Humana Medicare Advantage as of Jan. 1.

Livonia, Mich.-based Trinity Health is no longer included in Humana's Medicare Advantage network as of Jan. 1.

West Des Moines, Iowa-based MercyOne is no longer included in Humana's Medicare Advantage network as of Jan. 1.

Raleigh, N.C.-based WakeMed is out of network with Cigna Medicare Advantage as of Jan. 1.

Greenville, S.C.-based Bon Secours St. Francis Health System ended its participation with Cigna Medicare Advantage on Jan. 1.

CommonSpirit hospitals in Colorado and Humana went out of network on Jan. 1.

The Ohio State University Wexner Medical Center in Columbus went out of network with Anthem Medicare Advantage on Jan. 1.

WVU Medicine's Uniontown (Pa.) Hospital and its affiliated provider groups are no longer participating providers with Highmark PA or Highmark Wholecare Medicare Advantage as of Jan. 1.

Robbinsdale, Minn.-based North Memorial Health has ended its contract with Humana Medicare Advantage.

Duluth, Minn.-based Essentia Health went out of network with Humana Medicare Advantage plans in 2025.

Watertown, S.D.-based Prairie Lakes Healthcare System dropped Humana Medicare Advantage.

Nashville-based Vanderbilt Health is no longer in network with BCBS Tennessee Medicare Advantage.

Sioux Falls, S.D.-based Avera Health ended participation as an in-network provider with Humana Medicare Advantage, effective Jan. 1.

Quincy, Ill.-based Blessing Health implemented a new MA approach in 2025 and is only contracting with BCBS, UnitedHealthcare, Molina and Total Retiree Advantage Illinois.

Lawrence, Kan.-based LMH Health no longer accepts Aetna or Humana Medicare Advantage, effective Jan. 1.

Sioux Falls, S.D.-based Sanford Health dropped Humana Medicare Advantage in Minnesota for 2025.

North Platte, Neb.-based Great Plains Health no longer accepts any Medicare Advantage plans as of 2025.

Kimball (Neb.) Health Services no longer accepts any Medicare Advantage plans as of 2025.

Carson City, Nev.-based Carson Tahoe Health is no longer in network with Alignment Health and Molina Medicare Advantage as of Jan. 1.

Midland-based MyMichigan Health is no longer participating in the Aetna Medicare Advantage network in 2025.