Dismantling Rural Access: MA Plans terminate rural healthcare providers, force patients to drive further for care, and then retain higher payments intended to support local access to healthcare

Becker's Healthcare January 2, 2025
Mike Thompson, Healthcare Policy Analyst and Media Liaison, Louisiana Hospital Association

As rural Medicare Advantage (MA) expansion grows, more insurers are terminating local providers from their networks and requiring rural seniors to travel much longer distances for care. Critics say these changes provide a hidden windfall for MA plans while weakening rural access in ways Congress never intended.

National policy experts warn that MA plans have a financial incentive to enter rural areas and eliminate seniors’ convenient, local access to care. As this article will explore, rural low-volume providers receive enhanced payments under traditional Medicare to help cover their fixed staffing costs. Complex rules for paying MA plans allow the insurers to keep these enhanced payment rates after severing local patient-provider relationships. Federal officials exacerbated this problem by removing safeguards that...

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