Our Work

Biosimilar uptake in the United States is limited. It has not been comprehensively studied in Medicare Advantage (MA).

As of 2020, 70% of Medicaid beneficiaries (57 million) were insured through Medicaid managed care (MMC), in which a private insurer covers a beneficiary’s medical care in exchange for fixed payments from state Medicaid agencies.1 A key role of MMC insurers is to negotiate prices with hospitals. MMC prices have important implications for government health expenditures and access to care for Medicaid beneficiaries. However, little is known about MMC prices.2 We used hospitals’ self-disclosed pricing information to characterize MMC hospital prices.

Are Medicare Advantage plans’ provider networks associated with beneficiaries’ receiving care from primary care clinicians with lower rates of avoidable hospital stays?