Presbyterian Healthcare Services to Discontinue Most Medicare Advantage Plans by 2027
Presbyterian Healthcare Services, a significant healthcare provider based in New Mexico, is set to discontinue most of its Medicare Advantage (MA) plans starting from the 2027 plan year, according to a spokesperson’s confirmation to Fierce Healthcare. This decision comes amidst the health system’s ongoing strategy to focus its resources on critical areas for New Mexicans.
Continued Coverage Until 2026
Despite the upcoming changes, people currently enrolled in Presbyterian’s MA plans will not experience any coverage disruptions in 2026. The health system will maintain its dual-needs MA plans, ensuring that essential services remain available to those who need them most.
A spokesperson for Presbyterian emphasized that remaining in the MA market would limit the organization’s capacity to invest in essential care services, workforce development, and access improvements within New Mexico. “For Presbyterian, continued existence in this market would limit our ability to invest in the care, workforce and access to serve New Mexicans where they need us most,” the spokesperson said.
Impact on Jobs and Commitment to Care
As part of this strategic shift, Presbyterian will eliminate 150 positions within its health plan operations, affecting several administrative roles. However, the spokesperson reassured that these cuts would not impact clinical care. Notably, the health system is actively recruiting for approximately 870 open clinical positions, highlighting its commitment to maintaining high-quality care.
If members have questions about the transition, they are encouraged to contact Presbyterian at 505-923-2000. “Presbyterian is focused on where we can make the biggest difference: providing high-quality care, expanding access and maintaining a strong, independent health care system for New Mexico,” the spokesperson conveyed to Fierce Healthcare.
Addressing Financial Challenges
Presbyterian has faced financial hurdles in recent months, leading to Fitch Ratings downgrading its credit outlook to negative in February. The rise in medical costs, a challenge faced by payers nationwide, significantly pressures the health system’s financial stability.
Nevertheless, Fitch recognizes the long-term operational stability that Presbyterian’s health plans provide, despite the recent challenges. In addition to MA plans, Presbyterian offers a diverse range of health plans, including individual market plans, Medicaid, and employer-sponsored plans, reflecting its extensive reach and versatility in the healthcare sector.
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