Growth of zero-premium Medicare Advantage plans in counties with high cancer mortality
Abstract
BACKGROUND: Zero-premium Medicare Advantage (MA) plans have rapidly become the most popular MA plan type in the United States, despite potentially restrictive benefit design. It remains unclear whether the growth of these plans aligns with the county-level cancer mortality. METHODS: We conducted a 2-part, county-level ecological study. First, using Centers for Medicare & Medicaid Services (CMS) enrollment data (2019-2024) and National Center for Health Statistics (NCHS) mortality data (2018-2022), we examined longitudinal trends in the market share of zero-premium MA plans overall and across counties by their cancer-mortality rate quartiles. Second, we performed a cross-sectional, mixed-effects logistic regression analysis of 2019-2024 plan-level data to evaluate the association between zero-premium MA and low plan quality (
Fields of Study & Subjects
Economic and Financial Impacts of Cancer
Healthcare Policy and Management
Health Systems
Economic Evaluations
Quality of Life
Publication details
- Journal / source
- JNCI Journal of the National Cancer Institute
- Publisher
- Oxford University Press (OUP)
- Volume
- 118
- Issue
- 6
- Pages
- 997–1005
- Publication date
- 7 January 2026
- Language
- EN