Key Facts About Medicare Beneficiaries in Rural Areas
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.
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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.
Using Medicare Advantage encounter data, this analysis finds that 62% of Medicare Advantage enrollees have at least one chart review record and that diagnoses added from chart reviews increase payments from CMS to insurers for 17% of enrollees. The use of chart reviews varies across the largest Medicare Advantage insurers.
This brief looks at premium changes for Medicare Part D stand-alone prescription drug plans between 2025 and 2026. For plans that were offered nationwide in 2025 and will continue to be offered in 2026, Part D enrollees in many states will see lower monthly premiums in 2026.
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.
Medicare Part D is a voluntary outpatient prescription drug benefit for people with Medicare provided through private plans, including stand-alone prescription drug plans and Medicare Advantage plans that offer drug coverage. This analysis provides an overview of Medicare Part D plan availability, premiums, and cost sharing in 2025 and key trends over time.
This analysis examines the recent growth of Medicare Advantage as a share of hospital inpatient days. Medicare Advantage rose from 13% to 25% of all inpatient days from 2015 to 2023, although there was wide variation among hospitals.
This analysis of trends in health insurers’ financial data shows that insurers’ gross margins per enrollee dipped slightly in 2024 across four markets, remaining highest in the Medicare Advantage market, followed by the individual (non-group) market, the fully insured group (employer) market, and Medicaid managed care. The analysis also examines insurers’ medical-loss ratios across the four markets.
CMS recently finalized policies as part of the 2027 Medicare Advantage final rule that both enhance consumer protections and roll back changes to the Medicare Advantage program that were intended to protect consumers. These changes have gotten less attention than payment issues and changes to the star ratings system, which also affect plan payments, but could have implications for Medicare beneficiaries.
With Medicare’s annual open enrollment period underway, a new KFF analysis finds that Medicare Advantage enrollees, on average, had access to just under half (48%) of the physicians in their area who were available to people enrolled in traditional Medicare. The finding illustrates a key tradeoff for beneficiaries in choosing Medicare Advantage. Such plans can be appealing to beneficiaries because they offer extra benefits and cap out-of-pocket costs without the need for supplemental coverage. But…
Virtually all (98.9%) of the 2.6 million Medicare beneficiaries enrolled in a Medicare Advantage plan that terminated coverage at the end of 2025 have at least one MA-PD available in 2026, including more than two-thirds (68.7%) who have the option of enrolling in a plan sponsored by the same insurer.
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