Medicare Advantage Networks Included 46 Percent of Physicians in a County, On Average
Medicare Advantage plan networks included 46 percent of all physicians in a county, on average, according to a new analysis from the Kaiser Family Foundation.
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Medicare Advantage: How Robust Are Plans’ Physician Networks?
ReportThis report takes an in-depth look at Medicare Advantage plans’ physician networks. The analysis draws upon data from 391 Medicare Advantage plans serving beneficiaries in 20 diverse counties in 2015. The report examines the size and composition of plans’ physician networks, the variation across counties, the inclusion of physicians by specialty, and the relationship between network size and other plan features, such as premiums and quality star ratings.
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FAQs on Medicare Financing and Trust Fund Solvency
Issue BriefIn discussions of Medicare’s financial condition, attention frequently centers on one specific measure—the solvency of the Medicare Hospital Insurance (HI) trust fund, out of which Medicare Part A benefits are paid. Based on current projections from the Medicare Board of Trustees, the HI trust fund is projected to be depleted in 2036, 12 years from now. These FAQs answer key questions about Medicare financing and trust fund solvency.
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10 Things to Know About Medicare Advantage Dual-Eligible Special Needs Plans (D-SNPs)
Issue BriefIn 2023, 5.2 million dual-eligible individuals were enrolled in a Medicare Advantage plan designed specifically for dual-eligible individuals, known as Dual-Eligible Special Needs Plans (D-SNPs). This brief highlights 10 things to know about D-SNPs, including national and state enrollment trends, plan availability, insurer participation, benefits, and prior authorization rates and denials
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10 Reasons Why Medicare Advantage Enrollment is Growing and Why It Matters
Issue BriefThis issue briefs lays out 10 reasons why Medicare Advantage enrollment has been growing and why we can expect more growth in the years to come.
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What to Know About the Medicare Open Enrollment Period and Medicare Coverage Options
Issue BriefEach year, Medicare beneficiaries have an opportunity to make changes to how they receive their Medicare coverage during the nearly 8-week annual open enrollment period. This brief answers key questions about the Medicare open enrollment period and Medicare coverage options.
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5 Questions About the Idea of Default Enrollment into Medicare Advantage Plans
Issue BriefThis 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.
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Medicare Advantage Payments to Increase Again
Quick TakeThe 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.
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Medicare Program Integrity and Efforts to Root Out Improper Payments, Fraud, Waste and Abuse
Issue BriefThis brief explains fraud, waste, abuse, and improper payments in Medicare and describes actions to ensure Medicare program integrity.
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Final Prior Authorization Rules Look to Streamline the Process, but Issues Remain
Issue BriefThis brief examines the final CMS regulations governing prior authorization in Medicare Advantage, Marketplace, Medicaid, and other plans, how they might address some current consumer concerns, and some issues that remain.