The Everett Clinic axing some Medicare plans

About 1,400 seniors treated at facilities of The Everett Clinic are being asked to switch to a new kind of Medicare plan by the end of next year if they wish to continue to receive care.

The clinic estimates $7.5 million a year in care for 20,000 Medicare patients isn’t covered by the federal government and instead is subsidized by other patients and insurance, said Rick Cooper, CEO of The Everett Clinic.

To balance the scales, the clinic has changed its policy to steer Medicare Advantage patients to a series of other Medicare plans that better cover the clinic’s costs, he said.

“We made a business decision to move in this direction,” Cooper said. “We have concluded that one of our strategies is to try to encourage our patients to participate in other Medicare Advantage plans because this allows us to almost break even.”

The move has The Everett Clinic proposing to break ties with at least nine plans that allow patients a-la-carte health care choices in doctors and clinics. These plans are paid more money by the federal government, however the additional funding never goes to the clinics or health care providers, Cooper said.

“We want to do business with medical plans that are committed to preventive care, wellness and coordinated care, who believe in directing the majority of the premium to care delivery, and those are the plans we’re going to work with,” Cooper said.

Under the plans favored by the clinic, primary care physicians act as gatekeepers, but also focus on wellness and preventive care, Cooper said. These health plans also pay the clinic more money for patient services.

The clinic’s bottom line might see a $500,000 to $750,000 improvement if the 1,400 patients can be persuaded to shift to other plans.

“Original Medicare” patients, about 60 percent of the clinic’s clients, are unaffected by the change, Cooper said.

Patients have until the end of next year to change plans. Cooper also plans to write to future Medicare patients before their 65th birthdays to steer them away from the subset of Medicare health plans the clinic will no longer honor.

The clinic estimates that the number of Snohomish County seniors over 65 years old will increase at the fastest rate between now and 2011. About 64,000 men and women were in that age bracket in 2006; that number is expected to be more than 78,000 in 2011, Cooper said.

There are a few windows of time to change plans between mid-November and April, and again at the end of next year.

Reporter Jeff Switzer: 425-339-3452 or

Free information sessions

Drop-in information sessions for patients of The Everett Clinic are planned in November and December, including time to talk with Medicare Advantage health plan representatives and hear about the policy change from the Everett Clinic leadership. The meetings are planned at the clinic’s conference center at 3830 Hoyt Ave., Everett.

Nov. 28: 10 to 11: 30 a.m.; 5 to 7:30 p.m.; special clinic presentations at 10 a.m., 5 p.m. and 6:30 p.m.

Nov. 30: 10 a.m. to noon; special clinic presentation at 10:30 a.m.

Dec. 12: 10 a.m. to noon; special clinic presentation at 10 a.m.

Plans not accepted by Everett Clinic after Dec. 31, 2008

Advantra Freedom, Aetna Medicare Open Plan, Care Assured, Coventry (First Health), Humana, Secure Horizons by United Healthcare (including Direct Premier Plan 300 and Direct Plan 3), Sterling and Unicare.

Talk to us

> Give us your news tips.

> Send us a letter to the editor.

> More Herald contact information.

More in Local News

A Mukilteo Speedway sign hangs at an intersection along the road on Sunday, April 21, 2024, in Mukilteo, Washington. (Ryan Berry / The Herald)
Long live the Speedway! Mukilteo’s main drag won’t be renamed

The public shot down the mayor’s idea to change the name: 77% voted ‘No’ in an online survey, with 95% opposed on Facebook.

Motorcyclist dies in crash on East Marine View Drive in Everett

Around 8 p.m. Tuesday, a motorcycle and a vehicle crashed into each other at the intersection of 11th street and East Marine View Drive.

Logo for news use featuring the municipality of Darrington in Snohomish County, Washington. 220118
Motorcyclist dies in crash on Highway 530

Jeremy Doyle, 46, was riding east near Darrington when he crashed into the side of a car that was turning left.

The Marysville School District office on Thursday, Aug. 31, 2023 in Marysville, Washington. (Olivia Vanni / The Herald)
‘Financially insolvent’ Marysville schools to get unprecedented oversight

Superintendent Chris Reykdal will convene a first-of-its-kind Financial Oversight Committee, he wrote in a letter Tuesday.

Woodside Elementary Principal Betty Cobbs on Monday, June 17, 2024 in Bothell, Washington. (Olivia Vanni / The Herald)
Everett’s first Black principal retires after 51 years

In her office, Betty Cobbs kept a black-and-white photo of herself at age 5: “I am right there, with dreams of becoming an educator.”

Junelle Lewis, right, daughter Tamara Grigsby and son Jayden Hill sing “Lift Every Voice and Sing” during Monroe’s Juneteenth celebration on Saturday, June 18, 2022. (Olivia Vanni / The Herald)
On Juneteenth: ‘We can always say that there is hope’

The Snohomish County NAACP is co-sponsoring a celebration Saturday near Snohomish, with speakers, music and food.

Granite Falls
Man, 35, dies from heart attack while hiking Lake 22

The man suffered a heart attack about 1½ miles into the 6-mile hike east of Granite Falls on Friday, authorities said.

36 hours after final show, Everett radio host Charlye Parker, 80, dies

When Parker got into radio, she was a rarity: a woman in a DJ booth. For the past 12 years, she hosted weekend country music shows at KXA.

Homeowners Jim and Chris Hall stand beneath their new heat pump, at right, inside their Whidbey Island home on Thursday, Sep. 7, 2023, near Langley, Washington. The couple, who are from Alaska, have decreased their use of their wood burning stove to reduce their carbon footprint. (Ryan Berry / The Herald)
Snohomish County to start ‘kicking gas’ in push for all-electric homes

Last year, 118 Whidbey Island homes installed energy-efficient heat pumps. A new campaign aims to make the case for induction stoves now, too.

Dr. Scott Macfee and Dr. Daniel Goodman outside of the Community Health Center on Wednesday, June 12, 2024 in Everett, Washington. (Olivia Vanni / The Herald)
Everett CHC doctors, feeling like ‘commodities,’ speak up on ailing system

At the Community Health Center of Snohomish County, doctors say they feel like “rats getting off a sinking ship.” They want it to get better.

Logo for news use featuring the municipality of Mountlake Terrace in Snohomish County, Washington. 220118
Man charged with shooting at ex-girlfriend, child in Mountlake Terrace

The man, 21, showed up to his ex-girlfriend’s apartment and opened fire through the door, new court records say.

People walk along Olympic Avenue past Lifeway Cafe and Olympic Theater that currently hosts Lifeway Church on Friday, July 7, 2023 in Arlington, Washington. (Olivia Vanni / The Herald)
Arlington churches waged covert ‘battle’ against Pride event, records show

Sermons, emails and interviews reveal how an LGBTQ+ nonprofit became the target of a covert campaign by local evangelical leaders.

Support local journalism

If you value local news, make a gift now to support the trusted journalism you get in The Daily Herald. Donations processed in this system are not tax deductible.