Health systems across the country are making very different bets on whether to be in the insurance business.
Carle Health, Michigan Medicine, Memorial Hermann, Providence, and UMass Memorial have all shuttered or sold their insurance arms within the last two years, while many others have shut down product lines in an effort to remain open.
But a smaller group of systems is moving in the opposite direction, launching new plans or expanding into markets next year. In interviews with Becker’s, leaders from those systems emphasized tight geographic footprints, existing value-based care infrastructure and long investment runways rather than rapid growth.
MultiCare
Tacoma, Wash.-based MultiCare Health System launched its new health plan in October, entering the Medicare Advantage market in three counties for 2027.
The launch has been more than a decade in the making, following the launch of a clinically integrated network and investment in an independent physician group that supports value-based, full-risk contracts.
“Our goal is to be a payvider, where we are both the insurer and the care provider,” James Lee, MultiCare’s CFO and executive vice president of population-based care, said. “That combination we think is especially important in our strategy to take care of the population.”
Mr. Lee said inadequate traditional Medicare reimbursement, costly prior authorization battles with large MA plans and the growing instability of payer-provider relationships all factored into the decision.
“The other aspect is that our contact with many Medicare members today happens once they show up in our emergency room,” he said. “We would like to change that relationship and help them stay well, and not have the first encounter with them be when they have an acute episode.”
St. Luke’s
Boise, Idaho-based St. Luke’s Health System will begin offering Medicare Advantage coverage for the first time in 2027.
The system first launched its health plan in 2023 with individual and employer-based coverage, growing to around 65,000 members across Idaho. The new MA plan will be available in seven counties where the system and its participating provider partners have the specialist coverage available to support a senior population.
Matt Wolff, president of the health plan, said the timing is a product of the system’s own maturity rather than a response to broader ongoing market upheaval.
“It wasn’t like we were targeting 2027 all along,” Mr. Wolff said. “It has just made the most sense for us to get our own infrastructure ready.”
St. Luke’s has been in full-risk arrangements since 2017, and the health plan functions as an extension of the health system’s clinically integrated network.
Mr. Wolff said two things have tripped up other provider-sponsored plans. First, plans that attracted members with rich supplemental benefits, aggressive plan designs or even payments to members found those tactics unsustainable over the long term. Second, many systems lacked systematic integration between the plan and the delivery system.
“The only reason we are doing what we’re doing is because of our integrated strategy,” he said. “It is not ‘let’s stand up a health plan to perform by itself in the community.’ It’s really an extension of the health system.”
Bronson
Kalamazoo, Mich.-based Bronson Healthcare recently announced Bronson Preferred, a health plan for employers in southwest Michigan, for 2027 benefits.
Third-party administrator Key Benefit Administrators is partnering with the system on the plan, which offers self- and level-funded arrangements. Bronson had historically dabbled in health insurance and considered various ways of supplying coverage in recent years, but the ideas were not always aligned with Bronson’s mission, Kevin Murdick, Bronson’s system director of managed care and revenue cycle support, said.
Bronson Preferred was spawned following a tense negotiation with a commercial payer at the end of 2025. The negotiation ultimately resulted in an agreement but not without “uncertainty about potential participation and a lot of disruption within the community,” Mr. Murdick said.
He said a risk-based, fully insured model would demand significant risk tolerance and infrastructure, something the system is not interested in. Bronson’s tight footprint and relatively even distribution of providers across its service area position it to serve employer clients well, he added.
“You have many systems that are much more dispersed, and, for lack of a better term, a gerrymandered type of service area map, and I think that is hard to provide a cohesive network for employers,” Mr. Murdick said.
“I don’t think that every health system can do this effectively,” he added. “What is your position in the market? Do you have the presence within the market to accommodate this? What is the level of saturation in your market?”
Health Alliance Plan by Henry Ford Health
Detroit-based Henry Ford Health grew its Medicare Advantage enrollment by nearly 46% year over year to more than 132,000 members as of mid-2026, picking up ground as competitors reduced service areas or cut benefits in Michigan.
Health Alliance Plan President Margaret Anderson said the growth reflects years of investment in network reach and integration, not a reaction to competitor exits. The plan recently expanded across Michigan’s entire Lower Peninsula, where about 96% of providers are now in-network.
Ms. Anderson said Henry Ford does not view MA as a high-margin line of business, with the goal to break even at roughly 1% margin and put every remaining dollar into benefits and affordability.
“As a regional plan and an integrated delivery system, we’re here for the long term,” she said. “We are not a payer that’s going to be in and out of counties, degrading benefits or doing service area reductions.”
WVU Medicine/Peak Health
Morgantown, W.Va.-based WVU Medicine launched its plan, Peak Health, in 2023 and has since grown from roughly 3,500 members to more than 12,000. The plan is also expanding into Pennsylvania for the 2027 plan year.
Ben Gerber, CEO of Peak Health and senior vice president and chief strategy officer of WVU Medicine, said the plan is not designed to be a profit center, but instead to improve the patient experience and reduce administrative frictions.
“If you’re looking to be in Medicare Advantage for profit, right now is not a good time to be in the market,” Mr. Gerber said. “If you’re looking to break even and improve member experience, it’s a great time to grow.”
Mr. Gerber added that most mid-sized systems cannot stand up an MA plan alone. Peak Health estimates it needs at least 30,000 MA members to reach administrative break-even, a threshold it has addressed in part by bringing smaller regional systems in as minority owners.
Presbyterian
Presbyterian Health Plan, part of Albuquerque, N.M.-based Presbyterian Healthcare Services, is winding down most of its Medicare Advantage plans for 2027. While the MA Dual Plus Special Needs Plan will still be available to those eligible for both Medicare and Medicaid, 30,000 health plan members will need to seek out new coverage.
Heather Thiltgen, president of the health plan, said Presbyterian’s ability to execute on its mission served as a “north star” with the decision.
“How do we make sure we invest in our communities? The losses we were experiencing in general enrollment and Medicare Advantage made that difficult to do,” she said. “It is a very big financial drain on us.”
Ms. Thiltgen said Presbyterian’s emphasis on its mission is driving its continued D-SNP focus.
“When we look at our mission and helping the most vulnerable New Mexicans, certainly the D-SNP population is there,” Ms. Thiltgen said. “…I call it the magic in the middle, and it’s the overlap between the payer and the provider space. Our integrated delivery network is a place where we can partner.”
“When you look at how Medicare Advantage is set up, we do believe that it’s more and more a program where large national [carriers] can be more successful with it,” she added.
Providence
Renton, Wash.-based Providence announced in May that it would wind down most of its 40-year-old insurance business after the plan lost more than $100 million last year. A deal to keep Providence’s MA plans running through a national carrier later fell through, and the entire insurance business is now set to close.
In a a news release, Providence CEO Eric Wexler called the current environment “an untenable situation” and cited challenging market forces, state and federal regulations, and the scale advantages of national competitors.
The health plan closure is part of a broader financial restructuring at Providence, which has also sold its health IT consulting business and other assets as part of an effort to return the 51-hospital system to sustained profitability. The system has since posted more than a year of positive operating margin.
