Kettering Health in Ohio and Lehigh Valley Health Network in Pennsylvania have already ended their Medicare Advantage contracts with major insurers, and Becker’s Hospital Review’s ongoing tally of health systems walking away from Medicare Advantage counts both among roughly two dozen systems that have done the same in 2026. Unlike an insurer leaving a market, a hospital dropping a plan’s network does not end anyone’s coverage — it just moves the hospital outside it, leaving patients holding an insurance card that no longer buys in-network access to doctors and facilities they may have used for years.
When the Hospital Walks Away Instead of the Insurer
Kettering Health ended its Medicare Advantage contracts with Humana and Devoted Health effective January 1, 2026, after what the health system described as months of failed negotiations over claim denials, reduced payments and administrative burden that made the contracts untenable. Becker’s Hospital Review’s running list of health systems dropping Medicare Advantage contracts places Kettering alongside Lehigh Valley Health Network, which went out of network with UnitedHealthcare’s Medicare Advantage plans on January 25, 2026, after a similar breakdown in contract talks.
Both systems point to the same underlying complaint driving hospitals across the country to make the same call: Medicare Advantage insurers denying or delaying a higher share of claims than Original Medicare, forcing hospitals to spend more on appeals staff and wait longer to get paid for care already delivered.
Neither exit is isolated. Becker’s tracking shows roughly two dozen health systems made the same decision at some point in 2026, up from a smaller count the year before, and the reasons cited — denial rates and payment speed chief among them — repeat almost identically from one system’s public statement to the next.
The dispute pattern behind both exits is consistent: a hospital system spends months escalating specific complaints — a spike in prior-authorization denials, claims paid weeks or months late, or reimbursement rates that stopped keeping pace with actual treatment costs — before concluding that continuing the contract costs more in staff time and delayed cash flow than walking away does. Kettering said publicly that it pursued formal discussions with Humana and Devoted Health for months before deciding no agreement was possible; Lehigh Valley’s break with UnitedHealthcare followed a comparable trajectory.
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The Bill That Follows an Out-of-Network Hospital Visit
Federal rules require every Medicare Advantage plan to cover true emergencies anywhere, in-network or not, at in-network cost-sharing. Routine and scheduled care carries no such guarantee: a Humana or Devoted Health member who keeps seeing a Kettering-affiliated doctor for a non-emergency visit, and a UnitedHealthcare member who continues scheduled care at a Lehigh Valley facility, can both face full out-of-network billing, or find the plan will not cover the visit at all outside a narrow set of exceptions.
That exposure lands hardest on patients mid-treatment — someone managing ongoing cancer care, a recent surgery, or a chronic condition tied to a specific specialist at one of these systems does not have the option of simply waiting for the next enrollment window before the next appointment comes due. Some insurers extend a temporary continuity-of-care accommodation for patients already mid-treatment when a network changes, but it is not a guaranteed right the way emergency coverage is, and it varies by plan.
Patients can confirm their own exposure before a bill arrives by calling their insurer’s member services line or checking the plan’s online provider directory for Kettering or Lehigh Valley facilities specifically, since a directory listing a hospital system as in-network for one service line does not guarantee every affiliated physician group is included on the same terms.
Why These Patients Can’t Simply Switch Plans Right Now
Unlike the members in Wellcare’s, Providence’s or UnitedHealthcare’s 2027 plan exits, Kettering and Lehigh Valley patients are not looking at a plan that itself is ending. Humana, Devoted Health and UnitedHealthcare are all still operating and still enrolling members elsewhere, which means the hospital’s exit does not automatically open a special enrollment period the way a full plan termination does — affected patients are bound to the standard enrollment calendar rather than an insurer-triggered exception.
That calendar gives two paths: the Medicare Advantage Open Enrollment Period each January through March, when someone already in a Medicare Advantage plan can switch to a different plan or Original Medicare, and the annual open enrollment period every fall, which runs October 15 through December 7, for changes that take effect the following January.
The pattern is not slowing down. Fairview Health Services in Minnesota is set to stop scheduling patients under UnitedHealthcare Medicare Advantage plans effective January 1, 2027, the same kind of hospital-initiated exit that hit Kettering and Lehigh Valley a year earlier. A patient watching that timeline has a genuine planning advantage Kettering and Lehigh Valley patients did not get: a known future date, rather than a contract break that lands with only weeks of public notice.
Between insurers cutting members loose in county after county and hospitals cutting insurers out of their networks from the other side, the map of places where a Medicare Advantage card reliably still works is shrinking from both directions at once — and a patient has no way to know which direction will hit their own coverage next until either the insurer or the hospital makes the call.
This article was researched and drafted with the assistance of artificial intelligence.
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