Medicare Advantage — a private plan alternative to traditional Medicare — is growing. In 2017, 33 percent of Medicare beneficiaries were enrolled in Medicare Advantage, up from 22 percent in 2008. Some policymakers have raised concerns that Medicare Advantage networks may have become excessively narrow, making it harder for an enrollee to find a doctor covered by their plan, but little is known about the breadth of these networks and how they may be changing.
It turns out that Medicare Advantage networks are actually relatively broad and may be getting broader, according to a new study led by Boston University School of Public Health (BUSPH) researchers.
The study, published in Health Affairs, found that the share of Medicare Advantage plans with broad networks increased from 80.1 percent in 2011 to 82.5 percent in 2015, and enrollment in broad-network plans grew from 54.1 percent to 64.9 percent over the same period. Narrow networks were associated with urban areas, higher average income, and having more physicians nearby, as well as more competition between plans.
“We haven’t found evidence that primary care networks in Medicare Advantage are particularly restrictive. This should be good news for folks concerned about insurers excessively restricting access to providers,” says lead study author Mr. Yevgeniy Feyman, a doctoral student in the Department of Health Law, Policy & Management at BUSPH.
Previous research has suggested that over a third of Medicare Advantage beneficiaries were in narrow networks, but these studies have relied on physician directories, which are prone to error, and only looked at brief periods.
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