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  • Medicare Advantage Hospital Networks: How Much Do They Vary?

    Report

    This report takes an in-depth look at Medicare Advantage plans’ hospital networks. The analysis draws upon data from 409 Medicare Advantage plans serving beneficiaries in 20 diverse counties that together accounted for about one in seven (14%) Medicare Advantage enrollees nationwide in 2015. The report examines the size and composition of plans’ hospital networks, the variation across counties, the inclusion of Academic Medical Centers and NCI-Designated Cancer Centers, and the relationship between network size and…

  • Medicare Advantage Insurers Will Collect at Least $12.8 Billion in Federal Bonus Payments in 2023—a Nearly 30% Increase from 2022

    News Release

    Federal spending on bonus payments to insurance companies that offer Medicare Advantage plans will reach at least $12.8 billion in 2023, according to a new KFF analysis. That is a nearly 30% increase from 2022, and more than quadruple the spending in 2015. These data come from one of three analyses released today by KFF that examine various facets of the Medicare Advantage program, which provides health insurance coverage to nearly 31 million Americans. KFF…

  • How Do Dual-Eligible Individuals Get Their Medicare Coverage?

    Issue Brief

    People who are dually eligible for both Medicare and Medicaid coverage can get their Medicare coverage in a variety of ways. The brief breaks out the data for traditional Medicare, Medicare Advantage plans that are available to all Medicare beneficiaries, and plans that are designed specifically for dual-eligible beneficiaries.

  • Medicare Advantage Plans Denied 2 Million Prior Authorization Requests in 2021, About 6% of Such Requests

    News Release

    Medicare Advantage plans denied two million prior authorization requests for health care services in whole or in part in 2021, or about six percent of the 35 million requests submitted on behalf of enrollees that year, a new KFF analysis finds. Prior authorization is intended to ensure that health care services are medically necessary by requiring providers to obtain approval before a service or other benefit is covered. While prior authorization has long been used…

  • A Review of 62 Studies Finds Few Big Differences Between Traditional Medicare and Medicare Advantage on a Variety of Measures

    News Release

    With the Medicare open enrollment period set to begin Oct. 15, a perennial decision faced by Medicare beneficiaries is whether to get their coverage through traditional Medicare or the private plans known as Medicare Advantage. A new KFF review of 62 studies published since 2016 that compares Medicare Advantage and traditional Medicare on measures of beneficiary experience, affordability, utilization, and quality finds few differences that are supported by strong evidence or have been replicated across…

  • Medicare Advantage Payments to Increase Again

    Quick Insights

    The increase translates into an additional $35 billion to Medicare Advantage plans in 2026 compared to this year….The increase in payments is larger than for 2025 (3.7%) or 2024 (3.3%), but below the increase for 2023 (8.5%), and comes at a time of increasing scrutiny over Medicare Advantage payments.