Medicare Advantage Disenrollment Trends in New York State Skilled Nursing Facilities

Medicare Advantage (MA) is a voluntary, alternative health insurance option available to Medicare eligible beneficiaries. MA is offered by a growing number of insurance companies and enrollment is expanding rapidly; in fact, MA coverage outpaces the “original” or fee-for-service (FFS) Medicare program in many markets. The “private option” offers cost savings and supplemental benefits in exchange for limitations to patients, specific to provider choice. While this cost/benefit dynamic clearly appeals to enrollees residing the community, the model generally does not create the same balance for residents of long-term care facilities. As a result, disenrollment from (or changes to specialized) MA plans is far more common in the institutional setting than the population at large.

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