ThinkTankWeekly

Do Medicare Advantage plans still pay hospitals prices close to Traditional Medicare’s?

Brookings | 2026-10-13 | health

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English Summary

Using 2025 Hospital Price Transparency (HPT) data, the Brookings analysis finds that Medicare Advantage (MA) plans continue to pay hospitals prices for both inpatient and outpatient services that remain closely aligned with Traditional Medicare (TM) rates. The study found little evidence that the ratio of MA-to-TM prices changes even as MA penetration increases. While the authors acknowledge that divergence is plausible, they tentatively conclude that MA prices are unlikely to significantly deviate from TM prices in the near term unless major policy shifts occur.

中文摘要

根據布魯金斯(Brookings)的分析,利用2025年醫院價格透明度(HPT)數據顯示,醫療保險優勢計畫(MA)在支付住院和門診服務的價格方面,仍與傳統醫療保險(TM)的費率保持高度一致。該研究發現,即使MA的滲透率增加,MA與TM的價格比率也缺乏變化證據。儘管作者承認價格背離的可能性存在,但他們初步結論認為,除非發生重大政策轉變,否則MA的價格在近期內不太可能顯著偏離TM的價格。

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