TL;DR
Turn your wind-down time into listening time
- Thousands of audiobooks, podcasts and originals
- Listen on your phone, tablet or Echo — also offline
- Cancel anytime
A study published in Health Affairs found that Medicare Advantage enrollees discharged to skilled nursing facilities in 2022 were less likely than traditional Medicare beneficiaries to enter five-star-rated facilities or the SNF closest to home. The researchers linked the differences to plan networks that may exclude higher-quality facilities, and said federal network standards may need to be strengthened.
People enrolled in Medicare Advantage were less likely than traditional Medicare beneficiaries to receive post-hospital care at a five-star skilled nursing facility, according to a study published in the November 2026 issue of Health Affairs. The researchers also found that MA enrollees were less likely to go to the facility closest to home, raising concerns about how plan networks affect access to post-hospital care.
The study examined more than 1.45 million Medicare beneficiaries discharged from hospitals to skilled nursing facilities in 2022. About 654,500, or 45% of the group, were enrolled in Medicare Advantage. On average, those enrollees had access to 61% of local SNFs, the study found.
Compared with traditional Medicare beneficiaries, people in MA plans with narrow SNF networks were 22% less likely to enter a five-star facility. Those in plans with broader networks were 13% less likely. The researchers also found lower likelihood of admission to the nearest facility: 18% for enrollees in narrow networks and 5% for those in broader networks. These percentages describe differences in likelihood reported by the study; the source report does not provide the underlying admission rates.
Facilities with higher quality ratings and stronger registered nurse staffing were more likely to be excluded from MA networks, according to the researchers. That pattern was present even among plans with relatively broad networks. The study also found that Black, Hispanic and Asian beneficiaries, along with people eligible for both Medicare and Medicaid, were more likely to be enrolled in plans with narrower SNF networks.
Network Limits May Shape Recovery Care
Skilled nursing care is a common part of recovery after a hospital stay: the source report says about one in five Medicare beneficiaries receive it. Where a patient is sent can affect access to facilities with different staffing levels and quality ratings, while distance from home can matter to patients and families seeking to stay involved in care.
The findings point to a distinction between the size of a plan’s network and the quality and location of the facilities within it. A plan may contract with many SNFs yet still leave out highly rated options. The study documents an association between MA enrollment and lower likelihood of receiving care at top-rated facilities; it does not establish that network design alone caused each patient’s placement or measure the effect on individual recovery outcomes.
The results may be especially relevant to groups more likely to be in narrower-network plans, including beneficiaries eligible for both Medicare and Medicaid. The researchers argue that network adequacy rules focused on whether a facility is available within a set distance may not fully address whether patients can reach high-quality care.
Popular right now
De'Longhi Dinamica Plus Fully Automatic Espresso Machine
Dyson W1 PencilWash Wet and Dry Cleaner with Dok Cordless Wet Floor Cleaner
Bose QuietComfort True Wireless Earbuds with Active Noise Cancellation, Black
As an affiliate, we earn on qualifying purchases.
How Medicare Advantage Networks Differ
Traditional Medicare generally allows beneficiaries to receive care from any provider that participates in Medicare. Medicare Advantage plans contract with provider networks, including skilled nursing facilities, as part of arrangements intended to manage costs and coordinate care. Those networks can limit which facilities an enrollee may use.
Federal rules generally require MA plans to include at least one SNF within specified travel distances and times for enrollees. The study’s authors said those requirements provide relatively limited protection for access to high-quality facilities. Their analysis focuses on beneficiaries discharged to SNFs in 2022; the source report does not describe results for later years or changes in network policy since then.
“This study found that narrow networks and the exclusion of high-quality SNFs from networks contributed to lower SNF quality in MA in 2022.”
— The study’s researchers, as quoted in Skilled Nursing News
What the Study Does Not Establish
The reported findings concern beneficiaries discharged in 2022; they do not show whether the same patterns persisted in later years. The source report does not provide the study’s full methods, confidence intervals, absolute admission rates, or detailed definitions of narrow and broad networks, so those cannot be assessed from the available material.
The results show differences in where patients received care, but the information provided does not establish why each patient was admitted to a particular facility or whether network restrictions were the sole reason. It also does not report patient-level health outcomes, such as recovery or readmissions, or quantify how much any proposed regulatory change might improve access.
Possible Review of SNF Network Rules
The study authors called for policy efforts to strengthen network standards, especially by increasing the number of high-quality SNFs included in MA networks. The source report does not identify a specific rulemaking schedule, government response, or policy proposal already underway. Any regulatory change would require action beyond the study itself.
Further analysis of newer enrollment and discharge data could help establish whether the 2022 patterns continue and whether network composition has changed. For now, the study adds evidence to debate over how federal oversight should assess not only whether plans offer nearby SNFs, but also whether their networks include facilities with stronger quality measures.
Key Questions
What did the study find about Medicare Advantage patients?
Among patients discharged to skilled nursing facilities in 2022, Medicare Advantage enrollees were less likely than traditional Medicare beneficiaries to enter a five-star-rated facility or the SNF closest to home.
How many beneficiaries were included?
The researchers examined more than 1.45 million beneficiaries discharged from hospitals to SNFs in 2022. About 654,500, or 45%, had Medicare Advantage coverage.
Did the study prove that Medicare Advantage networks caused the differences?
The researchers linked narrow networks and exclusion of higher-quality facilities to lower SNF quality among MA enrollees. The source material reports differences and the researchers’ interpretation, but does not establish that network design alone caused each placement.
What changes did the researchers suggest?
They said federal network adequacy standards may need to be strengthened, with attention to including more high-quality skilled nursing facilities in Medicare Advantage networks. The source does not report that a policy change has been adopted.
Source: skillednursingnews.com
