Assessing The Inclusion Of Federally Qualified Health Centers In Medicare Advantage Networks.

Giron NC, Meyers DJ, Cole MB, Wright B, Trivedi AN. Assessing The Inclusion Of Federally Qualified Health Centers In Medicare Advantage Networks. Health affairs (Project Hope). 2026 Feb 1; 45(2):175-183, DOI: 10.1377/hlthaff.2025.00881.

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Abstract:

Medicare Advantage (MA) disproportionately enrolls low-income and racial and ethnic minority populations that may benefit from access to federally qualified health centers (FQHCs). Using 2022 FQHC provider and MA network data, we examined the inclusion of FQHCs in MA provider networks. On average, these networks included 57 percent of FQHCs in their service areas, but 30 percent of contracts had narrow FQHC networks, defined as including fewer than one-quarter of available FQHCs. Asian/Pacific Islander, Hispanic, and Black beneficiaries were more likely to be enrolled in a narrow-network contract than White beneficiaries by 26, 20, and 5 percentage points, respectively, which appears to have been driven by area-specific factors. Contracts lacking a star rating, operating in a single state, or enrolling fewer disabled or rural beneficiaries were more likely to have narrow networks. As MA enrollment grows, efforts to monitor in-network access to community-based safety-net providers are important.