Sanford Health has announced that it will terminate its partnership with Humana Medicare Advantage effective December 31, 2024. This decision comes amid ongoing challenges related to coverage denials and delays in patient care, prompting the healthcare provider to prioritize the best interests of its patients. Martha Leclerc, Vice President of Corporate Contracting at Sanford Health, emphasized that the decision was made to ensure better healthcare access for patients [76a06491]. Patients currently enrolled in Humana plans are advised to explore new insurance options during the Medicare Open Enrollment Period, which runs from October 15 to December 7. Those who choose to retain their Humana plans after 2024 will face out-of-network costs for services at Sanford Health facilities, necessitating careful coverage network checks for any scheduled procedures in 2025. Meanwhile, Good Samaritan Society locations will remain in-network for patients [76a06491].
In a broader context, Humana has been facing significant pressures in the healthcare sector, losing over 30% of its value since last fall. The company has struggled with profitability in its Medicare Advantage plans, which account for approximately 88% of its revenue. Analysts project that while Humana's profit margins may recover to historical levels by 2025, the new normal could be around 2%, significantly lower than previous margins [0c23e5c7]. The ongoing challenges in the Medicare landscape, including rising healthcare costs and regulatory pressures, have raised concerns about the sustainability of Humana's business model, especially as it relies heavily on government funding for its Medicare programs [0c23e5c7].
As the healthcare landscape continues to evolve, the termination of the partnership between Sanford Health and Humana serves as a critical reminder for patients to stay informed about their coverage options and the implications of such changes on their healthcare access and costs.