Essentia Health will cease accepting Medicare Advantage plans from UnitedHealthcare and Humana starting January 1, 2025. This decision affects approximately 20,000 patients, including 14,000 in Minnesota.
The Duluth-based health system announced the change in a press release on Tuesday, citing that UnitedHealthcare and Humana have delayed and denied care approvals at more than twice the rate of other Medicare Advantage plans. Dr. Cathy Cantor, Essentia’s chief medical officer for population health, emphasized the strain that these practices place on patients.
“This decision was not made lightly,” Dr. Cantor said. “Frequent denials and delays negatively impact our ability to provide timely and appropriate care. This is the right thing to do for the people we are honored to serve.”
In response, a UnitedHealthcare spokesperson stated that the insurer had extended its contract with Essentia Health in July, covering existing Medicaid, Medicare Advantage, and employer-sponsored health plans through the end of 2024. The spokesperson noted that Essentia did not raise concerns about its participation in the Medicare Advantage network until last week. UnitedHealthcare expressed a commitment to work with Essentia to find solutions.
Earlier this summer, HealthPartners made a similar announcement, citing high rates of claim denials from UnitedHealthcare as the reason for their decision.
Essentia Health advised patients with UnitedHealthcare or Humana Medicare Advantage plans to explore alternative options during the Medicare open enrollment period, which runs from October 15 to December 7. Patients are encouraged to verify that any new plan is in-network with Essentia to avoid gaps in care. Alternative plans include Medica, UCare, EssentiaCare, Blue Cross Blue Shield of Minnesota and North Dakota, HealthPartners, Security Health, traditional Medicare, and Medicare supplemental plans.
Essentia Health operates healthcare facilities across Minnesota, Wisconsin, and North Dakota and is notifying affected patients to ensure continuity of care. Patients with questions can contact Essentia representatives for assistance.
