Medicare Advantage Networks Not Narrowing

The primary care networks offered by Medicare Advantage plans are broadening and not narrowing, as some people have long feared.

According to a study published in the journal Health Affairs, only 1.8 percent of Medicare Advantage plans offer narrow primary care provider networks, down from 2.7 percent in 2011.  Meanwhile, the proportion of plans offering broad networks has grown from 80.1 percent in 2011 to 82.5 percent in 2015.  In 2015, broad network plans enrolled 63.9 percent of Medicare Advantage participants, up from 54.1 percent in 2011.

This is considered important because the proportion of Medicare beneficiaries enrolled in Medicare Advantage plans has risen from 22 percent in 2008 to 33 percent in 2017 (about 20 million people).

The study also found that HMOs are more likely to have narrow networks than point-of-service (POS) or preferred provider organization (PPO) and that narrow network plans are more likely to be found in markets with less Medicare Advantage penetration.

Learn more in the Health Affairs study “Primary Care Physician Networks in Medicare Advantage,” which is summarized in an article from the Commonwealth Fund, which supported the research, titled “Most Medicare Advantage Plans Offer Broad Primary Care Provider Networks.”

 

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