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Hark! ’Tis Medicare Advantage season, and tens of thousands in Portland’s 65-plus contingent are—or will soon be—celebrating by undertaking the annual quest for a health care plan.
This year, though, prices are up and the pickings look mighty lean. Glance no further than Providence to see the changes afoot.
For decades, tens of thousands of Portland-area seniors accessed the medical system’s hospitals and services through Providence Health Plan’s Medicare Advantage insurance. Others got in through one of UnitedHealthcare’s own such packages.
Those days are coming to an end.
The Providence Health Plan is shutting down. UnitedHealthcare is ending its Oregon Medicare Advantage contract with Providence as it draws back from an insurance line that is no longer the cash cow of yore.
With some small exceptions, this leaves most Portland-area Medicare Advantage members who want to get health care through Providence with two main options. Switch to traditional Medicare, which Providence has no choice but to take. Or switch to the one general-use Medicare Advantage line the health system will accept around here in 2027, which is run by Devoted Health, a fast-growing private equity–backed Massachusetts operation that says it “brings together advanced data and AI with world-class clinical and service excellence”—and which has a minor prior history in Oregon.
Devoted did not respond to a request for comment. A Providence spokesperson tells WW, “Our agreement with Devoted gives Medicare Advantage beneficiaries in the Portland metro area an option to stay connected to Providence hospitals, clinics and clinicians in 2027.”
The spokesperson also notes that the challenges facing the Oregon health care system extend well beyond Providence.
This is true, including in the Medicare Advantage space. An analysis early this month by The Oregonian found that more than 162,000 Oregonians—including 23,000 in Multnomah County—are enrolled in Medicare Advantage plans that will be discontinued or no longer be offered in their county next year. And many more are on plans whose networks are so slimmed-down that it’s not clear they will actually be able to find a doctor in it.
For everyday people, this means, at least, an irritating, stressful scramble in the short term as they try to figure out whether they can keep seeing their doctor—and perhaps something worse down the line if the truth turns out to be that they can’t.
The changes are significant. Oregon Health & Science University will no longer be in-network for Regence BlueCross BlueShield plans. Another insurer, PacificSource, won’t be offering Medicare Advantage plans in Multnomah County next year at all. UnitedHealthcare and Legacy Health were also threatening to cut ties—until they publicly came to an accord late last month.
This last bit was a huge relief for Sue Kveton, an 81-year-old Northwest Portlander who gets a specific kind of Medicare Advantage through UnitedHealthcare. It was a relief because in recent years this insurance has gotten her into fewer and fewer places—an experience that could portend what is to come for others.
For many years, Kveton and her husband got care at Providence St. Vincent Medical Center. His doctors were there when he got an abdominal aortic aneurysm several years ago, again when he needed a stent, and again once more for a subsequent repair. A couple years ago, she says, he needed another one—and “they advised us that they were no longer going to take our insurance.”
She says the hospital has since then been wonderful in emergencies—it has little choice but to see them in its emergency department—but she’s also had to spend much of her time in the last two years finding specialists for herself and her husband who take their insurance, which provider after provider has begun to reject.
Kveton blames UnitedHealthcare for not paying adequate rates. Others say providers should better contain costs. Either way, the fact is that, even in retirement, managing the bureaucracy of her husband’s medical treatment has become a major part of her life.
“My career is now managing his health care,” she says.
