60,000 Minnesota Seniors Face Network Changes as Providers Exit Humana

In a significant move, North Memorial Health and Avera Health have announced they will exit the Humana Medicare Advantage network starting January 1, 2025, impacting nearly 60,000 seniors in Minnesota. The decision follows a trend where various health systems are dropping out of Medicare Advantage plans due to disputes over payment rates, excessive claim denials, and administrative burdens. As health analysts suggest, this could lead to seniors reevaluating their insurance choices during the upcoming open enrollment period. Multiple reputable health systems including HealthPartners, Sanford Health, and Essentia Health have also opted to leave Medicare Advantage networks for Humana and UnitedHealthcare, citing similar issues. With Medicare Advantage plans increasingly covering a significant portion of the market, these changes raise questions about access to care for beneficiaries and possibly signal a shift in the relationships between insurers and health providers. Humana and other insurers claim that rising demands from health systems during negotiations are not sustainable, which may explain the escalating tensions and network exits. As the healthcare landscape becomes more complex for seniors, their options within Medicare Advantage will be severely limited unless negotiations reach a compromise, putting them at a higher risk of increased out-of-pocket costs for the upcoming year.