Essentia Health, a Duluth-based health system, announced it will withdraw from Medicare Advantage networks with UnitedHealthcare and Humana in 2024, the Minnesota Star Tribune reports.
The decision, which affects approximately 14,000 seniors in Minnesota, was attributed to high rates of claim denials and delayed payments from the insurers.
Essentia becomes the third large nonprofit health system in Minnesota to announce plans to leave Medicare Advantage networks this year. The health system stated that UnitedHealthcare and Humana have denial and delay rates more than double those of other Medicare Advantage plans, which has negatively impacted patient care, according to Dr. Cathy Cantor, Essentia’s chief medical officer for population health. Additionally, Essentia cited “excessive” prior authorization requirements that cause treatment delays.
While Essentia will remain in UnitedHealthcare’s networks for employer-sponsored and Medicaid plans in Wisconsin, both UnitedHealthcare and Humana have expressed a willingness to renegotiate contracts. UnitedHealthcare emphasized its commitment to resolving Essentia’s concerns and maintaining the partnership, while Humana indicated openness to discussions if a fair agreement can be reached.
The exits from these networks follow similar moves by other major Minnesota health systems, including CentraCare, Fairview Health Services, and HealthPartners. The changes will take effect on January 1, 2024, giving seniors time to explore other insurance options during the annual open enrollment period in the fall.
