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Primary Care Cost Sharing in Medicare Advantage
Changchuan Jiang, Chuan Angel Lu, Lesi He, Arthur S. Hong, Xin Hu, Megan Mullins, Boshen Jiao, Joshua M. Liao. JAMA Health Forum, 2026-07-10
Topic: Risk, prevention and care in population studies
Secondary outcomes included plan- and county-level factors associated with offering this benefit in 2025, estimated using multivariable mixed-effects logistic regression with county-level random intercepts. Results The proportion of MA beneficiaries enrolled in plans requiring no cost sharing for in-network PCP visits increased from 46.4% in 2019 to 78.1% in 2025 ( P for trend < .001), equating to approximately 15 million additional beneficiaries.
Key findings
- Secondary outcomes included plan- and county-level factors associated with offering this benefit in 2025, estimated using multivariable mixed-effects logistic regression with county-level random intercepts.
- Results The proportion of MA beneficiaries enrolled in plans requiring no cost sharing for in-network PCP visits increased from 46.4% in 2019 to 78.1% in 2025 ( P for trend < .001), equating to approximately 15 million additional beneficiaries.
Why it matters
This cross-sectional study found that the proportion of Medicare Advantage beneficiaries in plans with no cost sharing for in-network primary care visits rose from 46.4% in 2019 to 78.1% in 2025. It contains no research findings on treating, curing, or preventing Alzheimer's disease.
Study details
- Study designcross-sectional
- Effect size46.4%; 78.1%
- Evidence strengthModerate
How this study scored 50/100
Published in a peer-reviewed journal, and it is a snapshot of people at one point in time. Scored zero for sample size, studied in people and randomised / blinded because the record does not state it. We have no data on journal's citation record, times cited, citations per year, impact for its field and year, still being cited, senior author's track record, institution's track record and multi-centre collaboration, so those were left out: it earned 32 of the 64 points we could judge it on, which is 50 out of 100.
| Component | Points | Why |
|---|---|---|
| Journal tier | 7 / 10 | Tier 3 — peer-reviewed journal (JAMA Health Forum) |
| Journal's citation record | — / 4 | No journal record from OpenAlex — left out of this score |
| Study design | 4 / 12 | A snapshot of people at one point in time |
| Strength of evidence | 3 / 5 | Rated “moderate” in our summary |
| Peer-review validation | 10 / 10 | Peer-reviewed. Published as an article in a named peer-reviewed journal. |
| How recent | 5 / 5 | 2026 — within 1 year(s) of the newest study here |
| Sample size | 0 / 4 | Participant count not stated — scores zero (not stated in the record — scored 0) |
| Effect reported | 2 / 3 | Effect reported as a number, without an interval or test |
| Studied in people | 0 / 3 | Not stated whether this was studied in people — scores zero (not stated in the record — scored 0) |
| Randomised / blinded | 0 / 2 | No randomisation or blinding stated — scores zero (not stated in the record — scored 0) |
| Times cited | — / 7 | No citation count (not found in OpenAlex) — left out of this score |
| Citations per year | — / 5 | No citation count or no year — left out of this score |
| Impact for its field and year | — / 6 | No field-weighted citation impact (OpenAlex has none yet) — left out of this score |
| Cited by studies here | 0 / 6 | No other study in this library cites it |
| Still being cited | — / 4 | No yearly citation counts — left out of this score |
| Senior author's track record | — / 4 | Senior author's record not available — left out of this score |
| Institution's track record | — / 3 | No institution listed in OpenAlex — left out of this score |
| Multi-centre collaboration | — / 3 | Institutions not listed — left out of this score |
| Indexed in PubMed | 1 / 2 | Not in PubMed, but has a DOI |
| Free to read | 0 / 2 | Behind a paywall — scores zero |
| Points | 32 / 64 | Scored on 12 of 20 parts. We have no data for the rest, so they are left out: 32 of the 64 points we could judge it on is 50 out of 100. |
| Total | 50 / 100 | — |
What each of these 20 components measures, and what this score is not →
Read the original
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Cite this study APA, Vancouver, BibTeX · download .bib or .ris
Built from the record alzhub holds for this paper, not looked up. Volume, issue and page numbers are not held in the record. The record names 8 authors; APA and Vancouver show the first six, BibTeX and the downloads carry all of them. Check the citation against the original before you use it.
APA 7th
Jiang, C., Lu, C. A., He, L., Hong, A. S., Hu, X., Mullins, M., et al. (2026). Primary Care Cost Sharing in Medicare Advantage. JAMA Health Forum. https://doi.org/10.1001/jamahealthforum.2026.2232
Vancouver
Jiang C, Lu CA, He L, Hong AS, Hu X, Mullins M, et al. Primary Care Cost Sharing in Medicare Advantage. JAMA Health Forum. 2026. doi:10.1001/jamahealthforum.2026.2232.
BibTeX
@article{jiang2026-232a7005,
author = {Jiang, Changchuan and Lu, Chuan Angel and He, Lesi and Hong, Arthur S. and Hu, Xin and Mullins, Megan and Jiao, Boshen and Liao, Joshua M.},
title = {{Primary Care Cost Sharing in Medicare Advantage}},
journal = {JAMA Health Forum},
year = {2026},
doi = {10.1001/jamahealthforum.2026.2232},
url = {https://doi.org/10.1001/jamahealthforum.2026.2232}
}