Healthcare leaders often speak about the continuum of care as an ideal. For providers operating inside the system, it is anything but theoretical — it is operational, financial, and immediate.

Recent commentary from Providence Health’s CEO, reported by Becker’s Payer Issues, underscores what many provider organizations are already experiencing: Medicare Advantage reimbursement dynamics are increasingly misaligned with the cost, complexity, and coordination required to deliver longitudinal care. Providence’s call for a Medicare Advantage “reset,” alongside a growing wave of network exits, reflects operational strain — not philosophical disagreement.

At the center of this challenge is a growing disconnect between how care is delivered across a patient’s journey and how that care is reimbursed.

Continuity of Care Requires Continuity of Reimbursement

Providence cited materially higher denial rates, delayed payments, and administrative friction in Medicare Advantage compared to traditional Medicare. These pressures do not remain confined to revenue cycle teams. They cascade into staffing models, care coordination, access, and ultimately patient outcomes.

When reimbursement becomes unpredictable, continuity of care becomes fragile — not because providers lack commitment, but because the infrastructure required to sustain continuity depends on timely, reliable reimbursement aligned to patient need.

For LTC Operators, This Is Not Academic

For long-term care operators, continuity of care is measured daily in delayed authorizations, delayed admissions, denials, unpaid clinical effort, network exits, and referral volatility.

When continuity of reimbursement is impaired upstream, clinical continuity downstream fractures. Care plans are disrupted. Transitions slow. Teams are forced to compensate for system inefficiencies in real time. Providers are left repeatedly re-stitching the patient journey — often without the financial support intended to fund that care.

This is where the system quietly breaks — not in intent, but in execution.

Follow the Patient — and the Dollar — Across the Full Lifecycle

The takeaway from Providence’s position is not anti–Medicare Advantage, nor anti–value-based care. It is a recognition that payment models must follow the patient across the full continuum if outcomes are expected to improve.

When reimbursement aligns to the patient journey, care coordination becomes proactive, clinical planning extends beyond episodes, and operators can invest in infrastructure that supports outcomes instead of chasing denials. When it does not, providers are forced to follow the dollar — often at the expense of efficiency and continuity.

Assessment must come before execution. Execution must be measured against outcomes. And outcomes must reflect both patient experience and system sustainability.