Priority Health, the insurance arm of Grand Rapids, Mich.-based Corewell Health, is focused on long-term Medicare Advantage sustainability as the industry navigates rising costs and utilization.
Becker’s connected with Interim President Nick Gates about how the insurer continues to integrate its health plans with care delivery services for 1.3 million members, including 240,000 Medicare Advantage enrollees.
MA strategy headed into 2026
“Recent financial pressures have us really focused on sustainability. We’ve worked closely with our teams and agents, gathering feedback from our community to balance strong medical benefits and supplemental benefits that our members value. Our focus is on long-term sustainability.”
Where is utilization pressure coming from?
“Rising drug costs, high-cost injectables (particularly in oncology), and an increase in inpatient care. The biggest impact is from drug spend – GLP-1s, oncology medications, high-cost injectables, and gene therapies are all part of the long-term trend.”
Growth perspective
“Our focus has been on product design and sustainability and really providing an exceptional experience to our members and focusing on our core membership.
As an integrated system, we can provide a simple experience. We also have the ability to wrap programs around our members. So, our focus is on both experience and quality outcomes.
We’re committed to the markets we serve. We’re here for our agents, our members, and our communities. We saw last year that some of the large national insurers were pulling out of counties or areas that they felt weren’t profitable for them. We’ve committed to the state of Michigan, we’ve committed to the communities, and we’re here to stay. But we need to also focus on sustainability, which is why we’re looking at product design — those that balance what the member values and needs.”
What’s new at Priority Health?
“We are now operating in Indiana, Ohio and Wisconsin. We’re not in Medicare in those states yet, but that’s something we may look at down the road. What we continue to focus on is providing exceptional, high-quality products. We’re also looking at what the member values most. We were the first MA plan in Michigan to embed GRAIL Galleri, which is for early cancer detection. We’re committed to continuing to provide value-added services to our members in the markets we serve.”
