Hospitals signal Medicare Advantage exits as denials, underpayments strain margins

A growing number of hospital finance leaders are publicly considering exiting Medicare Advantage networks, citing unsustainable administrative burden and reimbursement shortfalls. The shift follows years of increasing prior authorization denials and downward pressure on payment rates from MA plans, which now enroll over half of all Medicare beneficiaries. For independent practices, this trend could mean reduced patient access for MA enrollees and increased pressure to accept traditional Medicare rates if local hospitals drop contracts. The move reflects a broader reevaluation of payer mix as provider margins tighten. This is a structural shift, not an immediate policy change, but it reshapes local referral networks and payer negotiation leverage.