UnitedHealthcare Dropped Us From Medicare Advantage. What Does That Mean for Patient Access?

UnitedHealthcare terminated us.

Not from our entire contract, only from its Medicare Advantage network.

The Sept. 1 letter says UHC is “making changes” to its network. Effective Dec. 1, The Hirsh Center for Arthritis and Sports Medicine will be excluded from Medicare Advantage contracts while remaining in UHC’s other plans. (We are appealing this decision)

The letter identifies no quality failure or performance deficiency. Our signature is not required.

We were once considered a top-performing practice by UnitedHealthcare. So what changed — perhaps the economics of caring for Medicare Advantage patients?

This is a network-adequacy warning.

In 2024, Florida Blue eliminated more than 70% of its Medicare Advantage rheumatologists in Palm Beach County. The Coalition of State Rheumatology Organizations (CSRO) documented that 32 were terminated and only nine remained. Centers for Medicare & Medicaid Services called the reduction significant, yet determined the network still met its standards.

Roughly 90% of Palm Beach County rheumatologists were unavailable to Florida Blue members because many had never participated. Among physicians still listed, many were approaching retirement, had recently retired or worked only part time.

CMS measures provider counts, addresses, time and distance. Those calculations do not reveal whether a physician is accepting patients, has capacity for medically complex transfers, can continue biologic therapy or can provide an infusion before the next dose is due.

A directory listing is not an appointment. An insurance card is not access.

Is UnitedHealthcare following the same playbook?

UnitedHealth Group told investors in January that its 2026 Medicare Advantage strategy “favored margin recovery” and projected 1.3 million to 1.4 million fewer members. Are network terminations part of that strategy? Is UHC limiting access to specialists who treat members with the most complex and costly conditions? If not, why remove a top-performing practice only from Medicare Advantage?

The Wall Street Journal and a 2026 Senate Judiciary Committee investigation examined UnitedHealth’s diagnosis-capture and risk-adjustment practices. Senate staff described “aggressive strategies” to maximize risk scores and payments.

If documenting sicker members produces higher taxpayer payments, why remove the specialists responsible for treating them?

This is why I call it Medicare Disadvantage.

UHC should disclose how many specialists it is removing by specialty and county, identify who remains and verify actual appointment capacity — not directory entries.

CMS should examine the cumulative effect before patients discover that an “adequate” network exists only on paper.

Have other practices received this letter?

👇🏻 COMMENT: Has UHC removed your practice only from its Medicare Advantage network? Share your specialty, county and state.