Washington, D.C. — Hospitals and health systems across the country are walking away from Medicare Advantage plans in growing numbers, and the federal agency that oversees Medicare just quietly shelved the rule that would have made it easier for seniors to follow them out the door.
The New York Times reported this week that nationwide, hospitals and providers are severing ties with private Medicare Advantage plans — citing persistent prior authorization denials, delayed reimbursements, and payment rates that don’t reflect the cost of care. UNC Health, a 20-hospital system in North Carolina, went out of network with Humana, WellCare, and Health Care Service Corp. at the start of 2026. Mount Sinai in New York City dropped Anthem MA. At least 19 major health systems have made similar moves, according to industry tracking.
For nursing home operators, the fallout isn’t abstract. When a hospital goes out of network with a patient’s MA plan, that senior often faces a messy, expensive choice: pay out-of-network rates or scramble to switch plans. Many don’t know they have the option. And when seniors can’t access their preferred hospital, post-acute discharge referrals — the lifeblood of skilled nursing census — get disrupted too.
CMS Shelved the Fix
Earlier this year, the Centers for Medicare & Medicaid Services had proposed a rule that would have let MA enrollees switch plans more easily when their providers leave a network. The proposal had broad support — the American Medical Association, the American Hospital Association, state insurance commissioners, and patient advocacy groups all backed it. Officials said it would streamline a complicated process and protect seniors from being stranded mid-care.
But early in April, CMS abandoned the proposal. No replacement rule has been announced. Network disruptions continue.
That decision lands hard at a moment when the MA network crisis is accelerating. Hospitals say insurers aren’t paying enough to cover rising costs. Insurers say they’re dealing with higher-than-expected medical utilization. Seniors are caught in the middle — and so are the nursing homes and rehab facilities that depend on hospital referrals to keep beds full.
Why This Matters for Skilled Nursing
The connection between MA network instability and skilled nursing isn’t always obvious, but it’s real. When a patient’s MA plan no longer includes their hospital, it can affect where they’re sent after surgery or a hospitalization. SNFs that aren’t on preferred MA vendor lists face reduced referrals. Patients covered by out-of-network hospitals may also face different authorization pathways before they’re cleared for post-acute placement.
Industry reports have increasingly flagged MA-related friction as a driver of delayed SNF admissions and shorter-than-necessary stays. As one earlier analysis found, Medicare Advantage is sending sicker patients to nursing homes while cutting their authorized stay short — adding financial and clinical pressure at the same time.
With the safety valve now gone and more hospitals likely to leave MA networks, that friction is only going to grow. Operators who haven’t audited which MA plans their feeder hospitals participate in may want to start now.
