Goodsurance
ES

Carriers & the market

MedPAC Report Finds Medicare Advantage Patients Stay in Hospitals 11 Percent Longer Than Original Medicare Patients

A MedPAC analysis released in June 2026 found that after accounting for patient mix, Medicare Advantage enrollees spent more time in the hospital than comparable original Medicare patients, complicating assumptions about how the program affects care use and hospital finances.

By the Goodsurance editorial teamJuly 7, 2026

Medicare Advantage enrollees had an average hospital length of stay 11.2 percent longer than comparable patients in original fee-for-service Medicare in fiscal year 2024, after researchers controlled for the hospital used, the services received, the patient's health conditions, and the intended post-discharge destination, according to Chapter 4 of the MedPAC June 2026 Report to the Congress released June 15, 2026.

The finding runs counter to the common assumption that Medicare Advantage plans consistently shorten hospital stays through aggressive utilization management. MedPAC researchers noted one plausible explanation: Medicare Advantage plans may sometimes prefer to extend a hospital stay rather than authorize a separate transition to a skilled nursing facility or inpatient rehabilitation facility, both of which require their own prior authorization approvals. That possibility would also be consistent with data showing elevated denial rates for post-acute care admissions among Medicare Advantage plans.

Medicare Advantage patients stayed in hospitals 11 percent longer than original Medicare patients in 2024, a new MedPAC report finds.

On the financial side, MedPAC found that hospital operating margins remained relatively flat or rose slightly between 2013 and 2024, a period during which Medicare Advantage penetration grew substantially. The stability suggests that the shift toward Medicare Advantage has not demonstrably harmed hospitals' aggregate financial position, even though Medicare Advantage payment rates are typically lower per case than traditional Medicare rates.

MedPAC noted that Medicare Advantage now covers more than half of all eligible Medicare beneficiaries, making MA enrollees a growing share of most hospitals' patient volume and revenue base.

In plain words

A group that advises Congress on Medicare looked at how long patients stay in hospitals. They found that people in Medicare Advantage plans stayed about 11 percent longer than people in regular Medicare when researchers compared patients with similar health problems. Some experts think this may happen because plans would rather keep patients in the hospital a little longer than approve a move to a nursing home or rehab center, which requires extra paperwork. The report also found that hospitals are making about as much money as before, even though more of their patients are now in Medicare Advantage plans.

Source: MedPAC
Read at the source →

More news

Other stories on what is moving in Medicare.

Carriers & the market

CVS Health Plans to Split Into Two Companies, Keeping Aetna and Caremark Together

The corporate parent of one of the largest Medicare Advantage insurers announced it will separate its insurance and pharmacy benefits arm from its retail drugstores by 2028, reversing roughly a decade of vertical integration.

November 5, 2026

Carriers & the market

Fairview Health Services Sued UnitedHealthcare for Listing It as In-Network in 2027 Medicare Advantage Plans After Exiting the Contract

A Minneapolis health system says UnitedHealthcare's open enrollment materials pointed current members to a provider directory that still included Fairview even after the system ended its contract. The case raises questions about directory accuracy during the annual enrollment window.

November 4, 2026

Carriers & the market

NewYork-Presbyterian and UnitedHealthcare Reach Another Extension, Keeping Medicare Advantage In Network Through November 30

The October 31 deadline passed without a permanent deal, but both sides agreed to extend in-network coverage one more month. With open enrollment running through December 7, New York-area beneficiaries who use NYP should watch whether a permanent agreement lands before year-end.

October 30, 2026

Carriers & the market

CVS Health Becomes Fifth Insurer to Sue CMS Over 2027 Medicare Advantage Star Ratings

CVS Health filed a federal lawsuit Monday challenging the methodology behind its 2027 Medicare Advantage star ratings, joining at least four other insurers in court after CMS released quality scores on October 8.

October 29, 2026

Carriers & the market

Centene Says WellCare's Medicare Business Will Break Even in 2026, a Year Ahead of Schedule

Third-quarter results showed lower-than-expected medical costs in Medicare Advantage and Part D, pulling Centene's recovery target forward by a full year as Medicare open enrollment continues.

October 28, 2026

Carriers & the market

Centene Becomes Third Insurer to Sue CMS Over Its 2027 Medicare Advantage Star Ratings

Centene filed a federal lawsuit October 22 arguing that CMS applied 17 measures a court already struck down to every plan except the company that won in court, depressing its 2027 scores.

October 27, 2026