Scripps Health has confirmed that its popular clinic and coastal medical groups will no longer accept Medicare Advantage plans from January 1, 2024. This decision will impact around 32,000 seniors in San Diego County who are enrolled in various plans from insurance companies such as SCAN, Anthem, Alignment, and Blue Shield. While rumors of the move had been circulating for months, the decision was confirmed by Chris Van Gorder, CEO of Scripps. Affiliated groups like Scripps Mercy Physicians Medical Group will continue to accept Medicare Advantage plans, but the coastal and clinic networks are highly sought-after by patients.
The withdrawal of Scripps Health’s coastal and clinic groups from Medicare Advantage plans has left thousands of seniors in search of alternative healthcare options. Some individuals, like Roc Rogers, who has been with Scripps since 2018, are considering supplemental health insurance to stay with their current doctors and specialists. However, the increased cost and potential denial of coverage make this an unaffordable and uncertain solution. Despite the inconvenience, Rogers appreciates the high-quality care he has received from Scripps and wishes to remain loyal. On the other hand, patients like Dave Averett have had dissatisfactory experiences with Scripps, with long wait times for appointments. For some, this decision is disappointing but not unexpected.
The decision to withdraw from Medicare Advantage plans has not been an easy one for Scripps Health. CEO Chris Van Gorder expressed that it was not the organization’s desire to make this move, but they cannot sustain continued losses from full-risk Medicare Advantage. Many major providers, including Mayo Clinic and Vanderbilt Health, have also opted out of Medicare Advantage due to dwindling margins. Increased labor and supply costs have contributed to Scripps Health’s first operating loss in recent history. Despite still having substantial funds, the organization needs the cash on hand to borrow additional billions for necessary facility repairs and seismic improvements mandated by state law. Continuing to operate at a loss and depleting savings would hinder future borrowing capacity and potentially lead to hospital closures, depriving communities of healthcare services.