Medicare Advantage at a Crossroads: Incentives, Access, and the Future of Care

Medicare Advantage (MA), also known as Part C, has become the dominant path through which older adults receive Medicare coverage. More than half of all beneficiaries — roughly 33–34 million people — are enrolled in plans operated by private insurers. These plans promise convenience and financial protection, including caps on out‑of‑pocket spending and some extra benefits not found in Original Medicare. At the same time, MA brings challenges that stem directly from how the program is designed, and these structural incentives can affect access to timely care, especially for people with complex health needs or limited provider options.