UNITEDHEELTH out of Medicare Advantage plans in 16 American provinces

Written by Amina Nias

New York (Reuters) -UNITEDHELHE said it would stop making Medicare Advantage plans in 16 American provinces in 2026, which affected 180,000 members, as the company balances higher costs with payment pressure in the insurance program.

“The mix (medical care services and medical services centers), high health care and increased use costs have created the opposite winds that no organization cannot ignore,” said Bobby Hunter, who runs the company’s government programs.

He said at a press conference on Tuesday: “United Holth is leaving the provinces, but it will continue to work in most states,” he said at a press conference on Tuesday.

The government pays private insurance companies to operate Medicare Advantage plans for people who are 65 years old, older or disabled. The company includes the company’s UNITEDHEALTHARE Insurance Company, the most registered member, before CVS Health and Humana.

UNITEDHEALTH has stopped its entire year’s directives this year, after it lost profits for the first time since 2008. The company instructed the profits of the first quarter, missing the unexpected costs in Medicare Advantage with the increase in members of the use of medical services.

UNITEDHELTH said in the second quarter profit call that the organizational changes stipulated in reducing the company’s payments to certain conditions would pose $ 4 billion on insurance profits in 2026.

I have put the flag in issuing the second quarter profits that can close some plans with about 200,000 members can help reduce the effect.

Compared to 2023, Hunter said government financing decreased in 2026 by about 20 %.

Hunter said that the company will stop operating more than 100 plannings, representing about 600,000 members of all, and it consists largely of the organizations of the favorite providers or those that allow members to see service providers outside the plan network.

Hunter said the exits are likely to direct patients towards health maintenance organizations, or plans that require more frequent referrals and restrict patients on a network of service providers.

“We need a sustainable model and allow us to raise people in those areas in an effective way,” said most of the plan to close the plan in rural areas.

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