SCAN, Sutter Health Announce Medicare Advantage Plans for 2026 Rollout

The agreement includes plans to establish a joint venture dedicated to MA products, pending regulatory approval.

SCAN Group and Sutter Health have announced a long-term collaboration to introduce new Medicare Advantage (MA) plans focused on Northern California starting in 2026. 

The agreement includes plans to establish a joint venture dedicated to MA products, pending regulatory approval.

The alliance seeks to address Medicare beneficiaries' complex and varied needs by designing specialized offerings. The partners stated that these plans would provide access to Sutter’s existing provider network, including hospitals, urgent care, digital health services, and chronic disease programs.

Aparna Abburi, CEO of Sutter Health Plan, said, “Taking a one-size-fits-all approach to the senior population doesn't work, and it's critical to reach different pockets within that group.” She added, “Some individuals are just now aging into Medicare and want to maintain continuity of care with Sutter providers. Others have been enrolled for years and have different social and behavioral needs.”

Integrated Care Approach, Expansion Under Review

Under the proposed 2026 plans, members will be assigned a Sutter Health primary care provider responsible for coordinating their care. The model will emphasize continuity and integration, particularly for older adults managing chronic conditions.

Sachin Jain, M.D., CEO of SCAN Group, emphasized the collaboration’s intention to align insurer and provider priorities. “For far too long, there's been kind of tension between payer and provider,” he said. “What we're trying to do is get us both on the same sides of the table... We want to partner with providers to enable them to do what they do best: to take care of patients.”

The collaboration also intends to demonstrate a more effective model for payer-provider relationships within Medicare Advantage. Jain stated, “We have an incredible opportunity here with Sutter to prove the art of the possible to the whole healthcare industry.”

While the initial rollout will be limited to Northern California, the joint venture may later expand to serve a broader Medicare population. Further developments will depend on regulatory review and approvals as required under federal Medicare Advantage program rules.

Conrad Vial, M.D., president of Sutter Health Network, highlighted systemic inefficiencies in prior payer-provider structures. “Payers and providers have generally operated in ‘parallel universes’, which can prevent both from realizing the potential of working together,” he said. “Oftentimes, mechanisms of association at an incentive level don't necessarily square very effectively because they haven't been co-created.”

No further plan details have been disclosed, and the final design and pricing structures will be determined closer to the launch timeline.