By Amina Niasse
New York (Reuters) -UNITEDHEALTH said that she will stop offering Medicare Advantage plans in 16 United States counties in 2026, which will affect 180,000 members, since the company balances the highest costs with the reimbursement pressure in the insurance program.
“The combination of financing cuts (Centers for Medicare and Medicaid services), the increase in medical care costs and the greatest use have created winds against that no organization can ignore,” said Bobby Hunter, who directs the company’s government programs.
UnitedHealth leaves the counties, but will continue to operate in most states, he said at a press conference on Tuesday.
The government pays private insurers to operate Medicare Advantage plans for people over 65 years of age or with disabilities. The company’s insurance business has the most registered members, ahead of the CVS Health and human rivals.
UnitedHealth suspended its guidance all year this year, after losing profits for the first time since 2008. The company attributed the first quarter to unexpected costs in its Medicare Advantage business as members increased the use of medical services.
UnitedHealth in a profit call from the second quarter said that the regulatory changes established to reduce the payments that the company receives for certain conditions would present a risk of $ 4 billion for insurance profits in 2026.
He pointed out in its launch of the second quarter that closing certain plans with about 200,000 members could help mitigate the impact.
Compared to 2023, Hunter said government financing will have decreased by 2026 by approximately 20%.
The company will stop operating more than 100 plans that represent about 600,000 members in total, largely composed of preferred suppliers organizations or those that allow members to see suppliers outside a network of plans, Hunter said.
The outputs will probably lead patients to health maintenance organizations, or plans that require more frequent references and limit patients to a network of suppliers, said Hunter.
Most of the closures of plans will occur in rural areas, said Hunter, where Unitedhealthcare is still working to rationalize operations: “We need a model that is sustainable and allows us to provide attention to people in those areas in a profitable way.”
(Amina Niasse report; Caroline Humer and Jane Merriman edition)
(Tagstotranslate) United (T) Bobby Hunter (T) Medicare Advantage (T) registered members
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