Nebraska hospitals are warning seniors to closely review their health coverage before enrolling in Medicare Advantage this fall, citing widespread issues with care denials, delayed treatment, and financial strain on local hospitals.
The Nebraska Hospital Association (NHA) released its 2025 Medicare Advantage Report Monday, based on responses from its 92 member hospitals. NHA President Jeremy Nordquist said nearly every hospital surveyed reported problems with prior authorization and reimbursement.
“Medicare Advantage plans deny care more often than traditional Medicare and can delay your treatment when you need it most,” Nordquist said. “98% of our hospitals reported that these prior authorization requirements negatively impact patients and delay necessary care.”
Medicare Advantage plans now cover 54% of all Medicare eligible individuals nationwide, a sharp increase from just over a third less than a decade ago. The Congressional Budget Office projects that the share of all Medicare beneficiaries enrolled in Medicare Advantage plans will rise to 64% by 2034.
According to NHA data, 89% of Nebraska hospitals say the shift to Medicare Advantage has hurt their finances, and 93% report increased administrative costs to comply with the plans’ policies. Nordquist said hospitals are spending more time fighting insurance companies than caring for patients, with some adding staff just to handle authorizations.
“We have 29 Medicare Advantage patients currently being held in hospitals more than a week after they were medically cleared for discharge because insurers hadn’t secured skilled nursing capacity,” he said. “It keeps patients separated from their families and drives up overall costs.”
Rural hospitals say the impact is especially severe. At Pender Community Hospital, CEO Laura Gamble said patients are often denied access to local recovery care.
“There’s nothing worse than telling a patient they can’t come to their hometown facility because their plan won’t authorize it,” she said. “It happens daily.”
In Grant, Perkins County Health Services CEO Neil Hilton said his hospital stopped contracting with Medicare Advantage entirely last year, calling it a “difficult but necessary decision.”
Similarly, Ivan Mitchell, CEO of Great Plains Health in North Platte, said his hospital’s productivity and patient satisfaction improved after dropping Medicare Advantage plans in January.
Jed Hansen, Executive Director of the Nebraska Rural Health Association, said the growing administrative and payment burdens threaten the future of small-town hospitals.
“Rural health care can’t be managed from an out-of-state call center,” Hansen said. “It needs local care kept local.”
The NHA urged seniors to consult trusted sources before enrolling or switching Medicare plans this fall and to ensure their providers are in-network.