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News
Medicare Advantage may be falling short for kidney patients. A new JAMA study found that end-stage kidney disease patients enrolled in Medicare Advantage had significantly lower kidney transplant and wait-listing rates compared to those on traditional Medicare — with younger and Hispanic patients hit hardest. Narrow networks and prior authorization hurdles may be key culprits.
A large retrospective study published in JAMA reveals a concerning gap in kidney transplant access depending on insurance type. Researchers analyzed data from over 630,000 patients with end-stage kidney disease (ESKD) between 2021 and 2023 — the first three years after the 21st Century Cures Act allowed ESKD patients to enroll in Medicare Advantage (MA) plans. The findings: MA enrollees consistently had lower transplant and wait-listing rates compared to those on traditional Medicare, and the disparity held steady across all three years studied.
The researchers point to structural barriers within MA plans — like narrow transplant center networks and prior authorization requirements — as likely contributors. Nephrologists are being urged to proactively monitor which plan their patients are enrolled in and watch for plan-related delays throughout the transplant process.
By the Numbers:
Why it matters: As MA enrollment among dialysis patients rapidly expands, these findings raise serious equity concerns — particularly for younger and Hispanic patients who already face systemic healthcare barriers. Policymakers and plan administrators need to examine how MA plan design may be limiting access to life-saving kidney transplants.
