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Medicare Medicaid
Why Insurers Are Exiting Medicare Advantage—and What It Reveals About Healthcare’s Risk Engine
Medicare Advantage plans are pulling out of unprofitable counties going into 2026 — not because they’re quitting the market, but because the math is breaking. Costs are rising faster than CMS payments, risk-score revenue is getting squeezed, and seniors are using more care. Here’s what that reveals about how insurers really make money on Medicare.
Medicare dollars follow CBSA wage indexes and CMS payment localities—not your “ZIP-level” maps. ZCTAs are 2020 shapes with annual ACS data, while USPS ZIPs change year-round. If analytics use ZCTAs but claims route by ZIP→locality, your denominators and dollars won’t match.
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