Inside the Collapse of Providence Health Plan

Don Antonucci, the chief executive at one of Oregon’s largest health insurance companies, would not give an interview for this story about how that business collapsed.

Yet his LinkedIn page offers a taste of his perspective, not only on business accolades—the Portland Business Journal recently ranked his Providence Health Plan among the region’s “most admired companies”—but also on leadership and life.

In one recent post, Antonucci recalls his positive experience after accepting a dinner invite, despite being quite tired, as evidence of the importance of “showing up—even when it’s not convenient.” In another, he reflects on a time his team pitched him a product, and what happened next.

I said no.

Not because the market wasn’t real.

It was.

Customers were asking. Competitors were moving. The case was serious.

It still didn’t clear the bar.

The disconnect, he reflected, was partly on him: He had failed to make his high standard explicit; it lived only in his head.

He made that last post about a month ago. This was some time after Providence Health Plan reported losing $102 million the previous year. It was months after the company’s move to outsource a huge line of business to a Silicon Valley artificial intelligence company ran aground. And it was weeks after his superiors at Providence Health & Services, the nonprofit health care conglomerate, said they would be putting the Portland-based health plan subsidiary up for sale.

The post came, however, before the more recent news—that the company had not actually found a buyer and that by year’s end it would be dissolved almost entirely, leaving hundreds of thousands of Oregonians to find new health insurance, one less not-for-profit player in an increasingly concentrated health insurance market, and the company’s 1,000 or so remaining employees likely without a job.

This was a dour bit of news to deliver, even for Antonucci. And he had an increasingly tough audience in the Providence Health Plan rank and file. More than a dozen current and former employees tell WW that resentment has surged in recent years as Antonucci and his largely out-of-state executive team seemed increasingly uninterested in, and even disdainful of, the perspectives of longtime company staff, radically undermining the character of an institution that many employees once regarded as the best place they’d ever worked.

Morale was not improved by the fact that multiple large rounds of layoffs last year had left everyone perpetually on edge, meaning the surprise companywide invite to a noon May 20 Microsoft Teams video call had basically scared the shit out of everybody.

The noon time slot was itself notable, staffers say, as it is Providence custom to leave the lunch hour alone. Nonetheless, staffers beamed in from their home offices to find an inscrutable Antonucci, clad in a suit jacket in front of a blurred background.

He was, he said in the video obtained by WW, about to deliver “significant news” that might bring up “a mix of emotions.”

He delivered the least bad news first. Providence was in talks with a national carrier to potentially take over its Medicare Advantage line of business, and the company was “evaluating options” for transferring its Medicaid plan to another organization. (These government-funded insurance lines make up a relatively small portion of Providence Health Plan’s membership.) Then came the worse news. “Beginning with the 2027 plan year, we will no longer be selling or renewing individual and family or any employer group commercial plans.”

In other words, in seven months time, the company would be essentially shutting down after four-plus decades in business.

For all its significance in Oregon, where it manages the health benefits of about 1 in 11 residents, Providence Health Plan is not all that big. Its revenue is about 8% of the roughly $30 billion slurped up by the genuinely massive Renton, Wash.-based Providence Health & Services. And after years of heavy losses, Providence—the mothership company—has been looking to cut weight.

Lately, it sold its labs and outsourced its home care and hospice business. Now it’s jettisoning its insurance wing too.

It is impossible to know if Antonucci, in his five years as health plan CEO, could have done anything to avert this outcome. His bosses blamed their decision to close on government “regulations” and structural advantages for huge insurers like UnitedHealthcare. PacificSource, another regional insurer, has struggled mightily too. Still, some Providence Health Plan staff couldn’t help but feel something essential was missing from the story: a top-down management style that in just a few short years radically altered a once-solid company and chased some of its best people away.

Providence did not answer a list of detailed questions for this story, but spokeswoman Melissa Tizon says the organization strongly disagrees with the characterizations outlined in the questions, and said the decision to sunset the plan “does not reflect the overall quality of the plan or the dedication of the caregivers who support it, including the Providence Health Plan leadership team.” (Providence calls all of its employees “caregivers.”)

Providence Health Plan’s tale begins in the mid-1980s when the cost of getting into the health plan business was relatively low and Kaiser Permanente was showing everybody the advantages of running not just a hospital system, but a medical group and a health plan—all integrated into one. Providence, then mostly only in the hospital business, was among those that followed suit.

One advantage is obvious: A health plan would route members to Providence providers. But policymakers like it too. Integrative health plans have different incentives. Rather than juicing utilization, health systems that get more revenue through premiums might seek instead to manage total cost of care.

In time, Providence Health Plan had more than half a million members. It got into the Medicare Advantage market. It managed self-funded plans for Intel and Portland Public Schools and, eventually, in a coup, got a contract for tens of thousands of public employees. The insurer got on the Affordable Care Act marketplace, selling insurance to individuals and group plans. And it partnered with the Oregon Health Authority to offer the Oregon Health Plan too. Still, even as the umbrella health care services company expanded to seven states, the insurance division remained largely centered on Oregon.

No private health insurance company is above withering criticism, but the health plan was by numerous accounts genuinely guided by more than money. Staffers remembered Christmas parties at OMSI, charity auctions, waltzing into top leaders’ offices to chat.

Benjamin Joy arrived at the health plan in 2016—coming from the tech world, he was struck by the gray hairs of long-tenured members on the interview team. The era of popular longtime CEO Jack Friedman had just ended, and a new CEO, Mike Cotton, had taken the helm. Joy and others say Cotton brought more of a business-y feel to the place, but he was essentially a convener in his decision making and seemed in tune with the organization’s Catholic roots. “Every meeting starts with a reflection,” Joy recalls. “It could be a prayer, a nice story, something thoughtful, trying to center us into what Providence is about. It wasn’t just about making money and selling health insurance.”

Seth Reams started at Providence as a temp in 2017, and before long was in the systems administration department, where he ran SQL queries to make sure providers and claims were loaded correctly. “You didn’t have to always account for or defend why you were trying to fix something broken,” he says. “You were given that leeway, and they trusted us.”

By Aug. 16, 2021, Cotton had moved along, and Providence named Antonucci, an executive for Blue Shield of California, to be its new health plan CEO. His starting annual pay was $1.9 million. Tizon, the Providence spokeswoman, says Antonucci has been an Oregon resident since 2010.

“At the start, I thought, ‘This guy might do well,’” Joy recalls. “He spoke a good game. But that was all before he started cutting everybody out of meetings…And then the layoffs started.”

Joy grants that it can sometimes be productive to have new blood come into a business and challenge its old ways. “But that’s not what happened.” He says he hates to say that the new management “thought we were stupid, because I’m making some assumptions there, but it sure felt that way.”

It wasn’t long before Antonucci began letting long-tenured senior leaders go, and the C-suite filled with his old associates—“cronies,” in Joy’s words—from BlueCross BlueShield. Many of them lived far from Portland, and seemed to longtime health plan staff ignorant of the dynamics of the region’s health care market.

A new management style crept in. Reams recalls that his team began to have to keep detailed records of what they were doing in 15-minute increments. “There was just zero trust in anybody. They’re like, ‘You don’t know what you’re doing. We do. We’ve been doing this a long time.’ I was like, ‘Well, that’s fine, but you don’t seem to understand Providence.’”

Reams remembers two instances in which he noticed a problem in the claims data that resulted in members paying more than they should have but was told by his bosses not to bother fixing it. Growing disturbed by the direction of the company, he quit last August.

Others didn’t get the chance. Joy noted that when his position was eliminated in 2024, he felt it conspicuous that he and everyone else getting ousted was over age 60. Another staffer, Kendrick Chane, tells WW that he was told in October 2024 his position was being eliminated just days after telling management he needed time off for a lifesaving surgery. He was told his removal had to do with certification requirements he lacked, but given that this had not prevented him from performing the role for the previous two years, he doubted this was a full explanation.

The COVID-19 pandemic was a very profitable time for the health insurance industry, and Providence Health Plan was no exception. Its net income in 2020 surpassed $140 million. But from 2022, as members started seeking health care again, it increasingly found itself in the red.

Some staffers feel the company could have better stowed away cash from this era. But Antonucci’s primary concern seemed to be dramatically expanding the health plan to more than a million members—drawing from new regions of Washington, Oregon and California, and beyond.

“We’re trying to expand everywhere, all the time, every direction,” says Caroline Soldani, a health plan employee since 2010 who currently works on the team that makes sure claims get paid correctly.

And yet in recent years, the plan’s member base persistently shrank. Where, as late as 2024, it reported more than 700,000 members, by early this year it reported 435,000. One notable hit came in 2025 when Providence Health & Services itself chose a different company, Aetna, to manage health benefits for its own employees. The exception was employees of Providence Health Plan, who continued to be insured through Providence Health Plan.

The insurance company never returned to in-person work after COVID. This inevitably changed its character, but Soldani, who manages a small team, says she has worked, with some success for a period, to keep a community going on Microsoft Teams—for example, maintaining a channel where people socialize and say what they did over the weekend.

Still, staffers say Antonucci and his out-of-state team seemed increasingly siloed and uninterested in their perspectives, and morale was tanking. In the spring of 2025, Antonucci announced the first round of major layoffs. He would follow up with another in the fall.

Still, even then it seemed from the outside like Antonucci was cooking up a future for Providence Health Plan. On Linkedin, Antonucci styles himself as an expert on emerging technologies. “I write about what’s actually happening in AI and health care—not the hype, the operator reality,” he writes in his bio. “If that’s useful to you, follow along.” And through much of last year, he and his team worked to outsource a major Providence Health Plan line of business to a Silicon Valley company that touted its AI technology.

The company, Collective Health, was founded in 2013 and reports “success managing claims, eligibility, and benefits administration for the employer health plans we serve.”

But five current and former Providence Health Plan employees privy to the partnership tell WW it quickly became clear the company had had little experience actually adjudicating and processing health insurance claims, but that when they warned their bosses that the contractor was not up to the task, health plan leaders ignored them, plowed ahead and, in many cases, laid off those who raised concerns.

“The right people weren’t included in the meetings,” one former staffer says.

As WW has reported, “Providence Health Plan Powered by Collective Health” went through a disastrous launch, disrupting health care for thousands. The two companies insist the situation has improved, but numerous providers and patients continue to report serious issues.

It is unclear to what extent the debacle factored into the overall health plan’s demise. Providence financial documents indicate that, before 2025 was over, top executives had approved a sale of at least some health plan assets.

But in any case, as the Providence Health Plan limps to a close, Soldani, the current staffer, feels the loss of so many qualified senior staff has left a vacuum. In some cases, she says, former staff had no chance to pass knowledge on. Or perhaps no one thought to ask. Maybe, she speculates, some felt resentful. “They’re like, ‘I just got screwed, so I’m not helping,’” she says. “But I didn’t see a lot of that. Everyone that is at Providence, they want us to succeed even if they’re not going to be here.”

Still, she says, the old, convivial character of the company is mostly gone. The social chat she tried to maintain on Teams has gone silent. “I have tried so many times to try to get people to open up,” she says. “And they’re just afraid.”