Carle Health announced on February 25 that its subsidiaries, Health Alliance and FirstCarolinaCare, will discontinue all lines of business except Medicare Advantage, effective January 1, 2026. These health plans intend to maintain operations to support claims processing and meet ongoing business needs through the end of 2025, as stated in a company announcement.
“The decision reflects a strategic assessment of the health plan’s competitive position and market dynamics,” said a Carle Health representative. “As a result, the health plans, including Health Alliance and FirstCarolinaCare, have decided to focus on core competencies and achieve greater operational and financial efficiencies.”
According to the Carle Health CEO, the majority of the combined health plan members have been or will be transitioned to the Medicare Advantage plan.
Health Alliance was established in 1988. Currently, it is a Carle Health-affiliated health plan serving approximately 195,000 members and offering Medicare Advantage plans.
FirstCarolinaCare was formed in 2002. Per the company, it is a Carle Health-affiliated health plan serving approximately 60,000 members.
While the organizations have worked over the past several years to enhance and expand care offerings, they have been unable to create a profitable model to support the expansion of services in the community.
“Our priority is to ensure the continuity of care for patients during this transition,” explained Carle Health CFO and VP, [Name Removed]. “Health Alliance has developed strategies to ensure we evaluate the impact of the changes on the health plan and continue to meet the care needs of members. Carle Health’s health plan members will not be negatively affected, and Health Alliance will diligently focus our efforts on providing our members and FirstCarolinaCare members with the resources to meet their healthcare needs.”
In 2015, Health Alliance expanded its operations to a new office on Devonshire Drive in Champaign, Illinois. This office is part of the company’s regional growth and service initiatives.
“Health Alliance and FirstCarolinaCare have created strong relationships over the past decades,” said [Name Removed], VP of Carle Health. “As the parent company of Health Alliance, we understand the importance of the services and the value that Health Alliance brings to the communities. We will ensure that the transition is transparent and seamless to all stakeholders for the next ten years.”
The organization is working with members, providers, and affected staff to ensure a smooth transition. Active engagement in the form of communication about the plan and the creation of a community plan is ongoing.
