Geographic variation and the dominance of SNP enrollment underscore that nursing homes face a fragmented and rapidly shifting payer landscape. The sharp rise in disenrollment upon nursing home admission suggests that coverage transitions are creating operational and financial gaps that SNF administrators must actively anticipate and manage.
Medicare Advantage Enrollment in Nursing Homes: 2010–2023
MA enrollment among long-stay residents increased from 12.9% in 2010 to 36.5% in 2023 — a 183% increase — outpacing MA expansion in the overall Medicare population. Institutional Special Needs Plans represented approximately 35% of MA enrollment for long-stay residents, and Dual-Eligible SNP enrollment ranged between 12% and 20% across study years. Disenrollment from MA sharply increased as beneficiaries entered nursing homes for long-term care. The substantial growth in MA enrollment among long-stay nursing home residents, coupled with the notable geographic variation and disenrollment, underscores the importance of recognizing that not all beneficiary groups experience MA in the same way. Targeted monitoring is needed to ensure that MA plans adequately address the care needs of this high-risk population.
— Journal of the American Geriatrics Society, November 25, 2025
Yun, Hyunkyung et al. “Medicare Advantage Enrollment in Nursing Homes: 2010–2023.” Journal of the American Geriatrics Society, 25 Nov. 2025. https://agsjournals.onlinelibrary.wiley.com/doi/10.1111/jgs.70206.
Enrollment in Medicare Advantage (MA) among nursing home long-stay residents increased by 183% from 2010 to 2023, according to a report published in the Journal of the American Geriatrics Society. Additionally, disenrollment for MA increased sharply as beneficiaries entered nursing homes for long-term care. The average age of MA beneficiaries was 85.4 in 2011 and 80.2 in 2023, while 61.4% of MA facilities were run for profit in 2011 compared to 72.9% in 2023.
— McKnight’s Long-Term Care News, November 14, 2025
✔ Comply with every payer's rules
✔ Equip your team with the Playbook
✔ Monitor rates and payer trends
