As some insurers and health systems pull back on their Medicare Advantage offerings for next year, Intermountain’s Select Health says it is strategically positioning itself for continued, long-term success in the program by focusing on key areas that will drive sustainability and growth.
Becker’s connected with Rob Hitchcock, president and CEO of Select Health, to discuss the company’s approach to navigating the challenges and opportunities in the Medicare Advantage space as it prepares for 2026. He shared his thoughts here:
“As we look at Medicare Advantage for 2026 and beyond, we still view it as a very critical product strategically. We see it as vital for us because, as a community health plan that’s part of a larger system, we aim to help people live as healthy as possible, and we can’t do that if we don’t serve these populations.
We’re looking at the program in three ways: First, we’re focused on what’s happening with risk adjustment and quality scores. Risk scores and quality are incredibly important, but I think they’ve become too administratively focused, so we’re working with the government to see if we can simplify the process. We want to make sure we continue to focus on high-quality care and be reimbursed adequately based on the members we serve, but this has become difficult under the current rules due to the complexity of the process.
The second way we’re looking at it is benefit design. Generally speaking, I think Medicare sees supplemental benefits as something they didn’t anticipate paying for. Through risk adjustment, the plans have taken that revenue and used it to pay for things like transportation, dental, food, vision — things that are not traditionally covered by Medicare. I think the complexity of risk adjustment and quality scores is forcing us to reevaluate those benefits. You’ll likely see other plans reconsidering their supplemental benefits as well.
The third way we’re evaluating it is geography. Some health systems and insurers have announced they’re withdrawing from Medicare Advantage, and I think others will follow. We’ve taken a hard look at where it makes sense for Select Health to continue offering benefits, but also where it makes sense to expand or retract. I think you’ll see many Medicare Advantage plans, including Select Health, really reconsidering their geographic footprints.
We’re looking at long-term success. To be successful in Medicare Advantage, you’ve got to have a strong clinical partner. For us at Select Health, we have a strong clinical partner in Intermountain Health, and I think that’s critical. Without a strong clinical partner, Medicare Advantage is only going to get harder. A strong clinical partner is really about delivering better outcomes, which is a key advantage of provider-owned plans.”
