Medicare Advantage

Federal spending on the Medicare Advantage quality bonus program has more than quadrupled since 2015, rising to at least $12.7 billion in 2025. Most Medicare Advantage enrollees are in a plan that receives a bonus payment in 2025, with employer- and union-sponsored plans receiving the highest bonus payments and special needs plans receiving the lowest bonus payments, on average.

This brief highlights key facts about Medicare beneficiaries living in rural areas, including their demographic and health characteristics, access to care, and satisfaction with care.

This brief considers how default enrollment into Medicare Advantage might work, potential challenges with this approach, and implications for beneficiaries, insurers, providers, agents and brokers, and the federal budget.

This analysis examines the share of Medicare Advantage enrollees in contracts (which usually include multiple plans) that offered rewards or incentives for completing health risk assessments (HRAs) in 2023, as well as differences across Medicare Advantage insurers.

To understand the role of Medicare Part D stand-alone prescription drug plans in serving rural Medicare beneficiaries, this data note analyzes 2025 Part D enrollment in PDPs and Medicare Advantage drug plans by geographic area nationally and at the state level.

While enrollment in Medicare Advantage, the private plan alternative to traditional Medicare, has grown steadily over the past decade, traditional Medicare remains the most common source of coverage for people who live in rural areas.

This brief explains fraud, waste, abuse, and improper payments in Medicare and describes actions to ensure Medicare program integrity.

The privatization of Medicare has been taking place without much public debate – a trend that has implications for the 68 million people covered by Medicare, health care providers, Medicare spending, and taxpayers. It’s not yet clear whether the administration will promote policies to accelerate the privatization of Medicare or focus more on achieving efficiencies and savings within Medicare Advantage, or pursue policies that aim to achieve both. How this plays out will have implications for beneficiaries, health care providers and insurers, and is worthy of serious debate.

In this JAMA Health Forum post, Executive Vice President Larry Levitt recalls the mid-1990s’ public backlash against Health Maintenance Organizations (commonly known as HMOs) – all of which preceded the recent outpouring of health insurance concerns – as well as how consumer protections against coverage restrictions have evolved and fallen short.

Nearly 50 million prior authorization requests were submitted to Medicare Advantage insurers on behalf of Medicare Advantage enrollees in 2023, of which 3.2 million (6.4%) were denied. Just 11.7% of denied requests were appealed, though 81.7% of appeals overturned the initial denial in Medicare Advantage. Substantially fewer prior authorization requests were made in traditional Medicare, reflecting the small number of services subject to prior authorization requirements.