(Lincoln, NE) - Today, the Nebraska Hospital Association (NHA) released the 2026 Medicare Advantage Report ahead of the Medicare open enrollment period, which runs from October 15 through December 7. The report highlights the challenges Nebraska patients and hospitals are experiencing with Medicare Advantage (MA) plans. 

The 2026 Medicare Advantage Report is based on NHA surveys of its 92 member hospitals and reveals that hospitals are continuing to have major challenges with MA plans. Reimbursement payments from MA plans are significantly less than those from Traditional Medicare for the same services and 94% of Nebraska hospitals say the shift to Medicare Advantage has negatively impacted their financial position. However, this year alone the federal government is projected to spend $76 billion more to cover MA enrollees than it would have if these beneficiaries were enrolled in Traditional Medicare.

Patients are feeling the impact as well. 96% of respondents say MA beneficiaries are often unaware of or misunderstand key aspects of their plan such as provider network restrictions, prior authorization requirements, or coverage limitations.

“Medicare Advantage plans restrict medically necessary services through prior authorization requirements, issue inappropriate denials, and create an immense administrative burden on the health care system,” said Jeremy Nordquist, President and CEO of the Nebraska Hospital Association. “Services or providers that would be covered under Traditional Medicare are often denied with a Medicare Advantage plan.”

According to a 2024 Senate investigative report, MA plans deny post-acute care at significantly higher rates than Traditional Medicare. These denials, often using AI-driven prior authorization, lead to delayed or premature discharge from hospitals and a reduced ability for patients to access necessary skilled nursing, rehabilitation, or home health services, resulting in poorer health outcomes and increased costs for seniors. 88% of Nebraska hospitals find it more difficult to get post-acute care approved for Medicare Advantage patients than Traditional Medicare patients.

Medicare Advantage plans deny care more often than Traditional Medicare and can delay

care when patients need it most. A staggering 94% of hospitals say prior authorization requirements by MA plans negatively impact clinical care by delaying necessary treatment.

Hospital staff are spending more time and money fighting insurance companies, time that could be spent on patient care. In fact, 88% of hospitals report that their overall cost to comply with MA policies has increased in the last three years and 88% feel that the administrative requirements of Medicare Advantage plans contribute to physician and staff burnout.

“We are urging seniors to review their options before enrolling or switching plans during this year’s Medicare open enrollment period,” said Nordquist. 

The NHA recommends policy changes for MA plans including reforming prior authorization policies, requiring timely approvals and payments, and aligning reimbursement to reflect the cost of care, as well as additional federal oversight and accountability for the program. Seniors should know the facts about Medicare Advantage and consult with their health care provider before enrolling or switching plans during open enrollment this fall.