Recently, health systems have been dropping their insurance arms like a bad habit. In April, Dallas, Texas-based Baylor Scott & White Health announced plans to stop offering Medicaid coverage by the end of August as well as individual plans on the Affordable Care Act (ACA) marketplace by 2027. Then in May, Renton, Washington-based Providence Health shared it would stop offering most of its health insurance options in 2027, too. Provider-sponsored plans rose in popularity in the 2010s as a way to align hospital and insurance incentives and encourage value-based care, which bases providers’ reimbursements on how well they keep their patients healthy. But recent years have tested that theory. High utilization, medical costs, turbulent federal policy, and the expiration of expanded ACA marketplace subsidies have rocked the health insurance market over the last couple years, prompting even major for-profit companies like Cigna and CVS’s Aetna to leave the marketplace or shrink Medicare Advantage (MA) offerings. The retraction of payviders isn’t a death blow to the concept, but experts say it suggests plans need to be very big—or very careful—to survive. Sometimes the best-laid plans can go awry.—CC, CM | 
