Researchers from Brown University Report Details of New Studies and Findings in the Area of Managed Care (Most Hospitals With Vertically Integrated MA Plans Charge Similar Prices To Affiliated And Unaffiliated Plans): Managed Care

2026 AUG 17 (NewsRx) -- By a News Reporter-Staff News Editor at Insurance Daily News -- Investigators publish new report on Managed Care. According to news reporting from Providence, Rhode Island, by NewsRx journalists, research stated, “Vertical integration between Medicare Advantage (MA) plans and hospital providers is increasingly common, but little is known about how vertically integrated plans pay affiliated providers for medical services. Providers may accept lower prices from affiliated plans to give those plans a competitive edge in the MA market.”

The news correspondents obtained a quote from the research from Brown University, “Conversely, plans may pay vertically integrated providers higher prices to increase their medical loss ratios-a measure of revenues spent directly on health care required by the Centers for Medicare and Medicaid Services. Using a novel data set of vertically integrated MA plans matched with negotiated hospital pricing data, we found that in 2024, 66-73 percent of hospitals charged similar prices to affiliated and unaffiliated plans, but prices differed at a sizeable minority of hospitals. On average, affiliated plan prices were 5.3 percent higher than unaffiliated plan prices for the same procedure at the same hospital. Affiliated plan prices were higher relative to unaffiliated plan prices in the inpatient (rather than outpatient) setting, in more concentrated MA markets, and where MA hospital prices were lower relative to traditional Medicare hospital prices.”

According to the news reporters, the research concluded: “Our results suggest that vertically integrated MA plans behave differently from standard MA plans, but strategies vary by market and hospital characteristics.”

This research has been peer-reviewed.

For more information on this research see: Most Hospitals With Vertically Integrated MA Plans Charge Similar Prices To Affiliated And Unaffiliated Plans. Health Affairs, 2026;45(8):871-879.

Our news journalists report that additional information may be obtained by contacting Geronimo Bejarano, Geronimo Bejarano, Brown University, Providence, Rhode Island. Additional authors for this research include Grace Mackleby, Mark Katz Meiselbach, David J. Meyers, Josephine Wilson and Erin Trish.

(Our reports deliver fact-based news of research and discoveries from around the world.)