Health Affairs July 21, 2025
Medicare Advantage (MA) now covers more than half of all Medicare beneficiaries. In rural areas, enrollment of Medicare beneficiaries in MA has surged from 11 percent in 2010 to 40 percent in 2023. The impact of MA on rural hospitals is not fully understood, but its rapid growth has raised concerns among rural health leaders that MA may threaten the financial stability of rural hospitals. This highlights a central policy paradox: Efforts by the federal government to expand MA through generous payment and flexibilities for plans may undermine the very institutions that lawmakers have long aimed to protect.
Rural hospitals serve populations with greater chronic disease burden, access challenges, and reliance on public insurance. They also operate under unique constraints:...
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