The count of hospital networks backing out of Medicare Advantage keeps climbing. A growing roster of large systems has now cut ties with or scaled back at least some of their private Medicare contracts for the coming year, and a separate academic analysis projects that roughly one in ten enrollees, close to 2.9 million people, will be pushed out of a current plan as a result. The exits concentrate the disruption on the very people who chose a plan to keep a trusted hospital or physician in network.
Why hospital systems are cutting Medicare Advantage loose
The reasons the systems give are strikingly consistent. Administrators point to prior-authorization denials that delay or block care their own clinicians recommended, and to reimbursement that arrives slowly and often below what the same service earns under Original Medicare. Hospital leaders describe entire teams devoted to appealing rejected claims and re-securing approvals that Original Medicare would grant automatically, an administrative drag that thins the margin on every covered patient. When a network spends more chasing payment than it collects, dropping the contract becomes a financial decision rather than a clinical one, and 2026 has produced a cluster of those decisions.
The running tally kept by Becker’s Hospital Review now counts twenty-five systems dropping or scaling back Medicare Advantage for the coming year, a roster that includes large names such as Mayo Clinic, Mount Sinai and UNC Health. Not every break originates with the hospital, either. In some markets an insurer terminated the relationship or pulled a plan entirely, leaving a network out of reach through no move of the provider’s own.
The roster reaches well beyond the marquee names. Houston-based Memorial Hermann and Blue Cross Blue Shield of Texas went out of network at the start of the year, Florida’s BayCare stepped back from certain Medicare Advantage plans, and Providence, which operates more than a dozen hospitals across California, fell out of network with a large national insurer. Several of those splits were driven by the carrier rather than the hospital, a reminder that a beneficiary can lose access even when the local system would prefer to stay.
The pattern is not brand new, but its pace is. Researchers count roughly 90 hospitals and health systems that have terminated some or all of their commercial Medicare Advantage contracts over the past three years, with the sharpest concentration landing in 2026. Each exit chips away at the central promise of a Medicare Advantage plan, which is a defined network a member can count on staying put from one year to the next.
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What forced disenrollment actually means for patients
Forced disenrollment happens when a plan stops being offered or a member’s providers fall out of network, leaving the enrollee no choice but to move. A study published in JAMA and summarized by the Johns Hopkins Bloomberg School of Public Health put the 2026 figure at about 2.9 million people, or one in ten Medicare Advantage members, the highest share the researchers had ever measured.
The trajectory is what alarms the authors. Annual forced disenrollment averaged just over 1% from 2018 through 2024, then jumped to 6.9% in 2025 before reaching 10% in 2026, a tenfold rise in two years. The JAMA analysis also found the burden falls unevenly, hitting people in PPO plans, plans from smaller carriers and plans with lower star ratings harder, and striking rural enrollees at nearly twice the rate of others.
For an older patient midway through treatment, a forced switch is more than paperwork. A new plan can mean a new drug formulary, a new prior-authorization process and, in the worst cases, the loss of a specialist who has managed a chronic condition for years. Continuity of care is the specific casualty; a cancer patient or someone managing heart failure may have to rebuild a treatment team from scratch, re-establish prior authorizations for existing prescriptions, and hope the new plan’s formulary still covers the same drugs at a similar cost. The 2.9 million figure is a projection built on plan filings, but the mechanism behind it is concrete, and it lands on households least able to absorb a scramble.
The open-enrollment window that lets affected seniors move
The one advantage of the timing is that the exits surface right before the annual chance to react. During the Medicare open enrollment period, October 15 through December 7, an affected member can switch to another Medicare Advantage plan that still contracts with the desired hospital, or return to Original Medicare and add a standalone drug plan. Changes made in that window take effect January 1.
Returning to Original Medicare carries a catch worth knowing before the deadline. A member who drops Medicare Advantage may want a Medigap policy to cover the gaps, but outside a person’s initial enrollment most states let insurers medically underwrite those policies, meaning health history can raise the price or block a plan. The clean exit a forced disenrollment seems to offer can narrow considerably once that underwriting enters the picture.
The wave of departures leaves a structural question hanging over the program. Medicare Advantage now covers more than half of all eligible beneficiaries, sold in part on the strength of its networks, and a year in which one in ten members is forced to move tests how durable that promise really is. Whether 2026 proves an aberration or the start of a trend will not be clear until the next round of plan filings lands.
This article was produced with AI assistance and reviewed against primary sources by The Money Overview editorial team.
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