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Assessing The Inclusion Of Federally Qualified Health Centers In Medicare Advantage Networks.

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Medicare Advantage plans often exclude federally qualified health centers (FQHCs), limiting access for minority populations. Many contracts feature narrow FQHC networks, disproportionately affecting racial and ethnic minority beneficiaries.

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Area of Science:

  • Health Services Research
  • Health Equity
  • Health Policy Analysis

Background:

  • Medicare Advantage (MA) plans increasingly enroll diverse populations, including low-income individuals and racial/ethnic minorities.
  • Federally Qualified Health Centers (FQHCs) are crucial safety-net providers for these vulnerable groups.
  • Understanding FQHC inclusion in MA networks is vital for ensuring equitable access to care.

Purpose of the Study:

  • To examine the extent of FQHC inclusion within Medicare Advantage provider networks in 2022.
  • To identify characteristics of MA contracts with narrow FQHC networks.
  • To assess disparities in enrollment within narrow-network MA contracts among different racial and ethnic groups.

Main Methods:

  • Analysis of 2022 Medicare Advantage contract data and Federally Qualified Health Center provider data.
  • Calculation of FQHC network inclusion rates within MA plans.
  • Comparison of beneficiary demographics across narrow versus broad FQHC network contracts.
  • Identification of contract-level factors associated with narrow FQHC networks.

Main Results:

  • On average, MA networks included 57% of available FQHCs, but 30% of contracts had narrow networks ( <25% FQHC inclusion).
  • Asian/Pacific Islander, Hispanic, and Black beneficiaries were more likely to be enrolled in narrow-network contracts compared to White beneficiaries.
  • Narrow networks were more prevalent in contracts lacking star ratings, operating in single states, or serving fewer disabled or rural beneficiaries.

Conclusions:

  • A significant proportion of Medicare Advantage contracts feature narrow Federally Qualified Health Center networks.
  • Enrollment in narrow-network MA contracts disproportionately affects racial and ethnic minority beneficiaries, suggesting potential access barriers.
  • As MA enrollment expands, monitoring network adequacy for essential safety-net providers like FQHCs is critical for health equity.