1 in 5 Medicare Advantage plans lack in-network access to academic medical centers, study finds

A Kaiser Family Foundation study of private Medicare plan networks finds that Medicare Advantage plans include about half (51 percent) of area hospitals in their network, on average, while one in five plans lack in-network access to academic medical centers. 

The study, which draws upon data from 409 plans in a geographically diverse sample of 20 counties in 2015, also found that two in five plans in areas with a National Cancer Institute-designated cancer center did not include the center in their networks.

Here are three other findings from the study.

1. Twenty-three percent of Medicare Advantage plans in Kaiser's study had broad hospital networks in 2015, while about 16 percent had narrow or ultra-narrow networks.

2. In 9 of the 20 counties studied, none of the plans offered in 2015 had a broad network of hospitals within that county, the study found. Those nine counties were Clark in Nevada; Cook in Illinois; Davison in Tennessee; Harris in Texas; Jefferson in Alabama; King in Washington; Los Angeles in California; Pima in Arizona; and Salt Lake in Utah.

3. For the study, Kaiser looked at 307 HMO plans. Among HMOs, broad and narrow network plans had similar average premiums ($37 vs. $36 per month) and similar quality ratings (3.8 vs. 4.1 stars).

 

 

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