The review searched CINAHL Complete, PubMed, EconLit and Scopus and followed PRISMA 2020 reporting guidelines. Reviewers screened titles and abstracts, examined full texts and hand-searched reference lists. They included US-based cohort and cross-sectional studies comparing skilled nursing facility quality or related outcomes for Medicare Advantage and Traditional Medicare beneficiaries. Study quality and risk of bias were assessed with the Newcastle–Ottawa Scale. Thirty-three articles underwent full-text review, and seven met the final inclusion criteria. The abstract does not report whether the results were pooled quantitatively, so the available evidence supports a summary of the included studies rather than a single combined effect estimate.

The findings differed by outcome domain and by population. Medicare Advantage enrollment was associated with a lower likelihood of admission to facilities with higher CMS ratings, yet several included studies found more favorable utilization outcomes at both the beneficiary and nursing-home levels. The review’s abstract does not specify which measures comprised every utilization outcome, so those results cannot be interpreted as a general finding of better care. It also reports that associations varied between short-stay and long-stay populations. The authors interpret the combination of favorable utilization findings and concentration in lower-rated facilities as suggesting possible misalignment between managed-care incentives and dimensions captured by publicly reported nursing-home quality measures, particularly for long-stay residents.

The review is limited to seven included studies drawn from an evidence base of cohort and cross-sectional research, and the abstract characterizes the findings as mixed. It does not provide effect sizes, confidence intervals or quantitative pooling in the supplied text, limiting assessment of the magnitude and precision of the reported associations. The authors state that additional research is warranted on whether existing quality-measurement approaches capture the dimensions of post-acute care performance most relevant to managed-care settings. The available evidence therefore supports an association between Medicare Advantage enrollment and the studied skilled nursing facility outcomes, but it does not establish that enrollment causes changes in nursing-home quality or utilization.

Subject of Research: Systematic review of Medicare Advantage enrollment and US skilled nursing facility quality

Article Title: Medicare Advantage and nursing home quality in the United States: a systematic review

Article References: Kim, H., Mahmood, A., Dobalian, A., & Chang, C. F. (2026). Medicare Advantage and nursing home quality in the United States: a systematic review. BMC Health Services Research. https://doi.org/10.1186/s12913-026-15741-2

Image Credits: AI Generated

DOI: 10.1186/s12913-026-15741-2

Keywords: Medicare Advantage, Traditional Medicare, nursing home quality, skilled nursing facilities, systematic review, health services research, quality ratings, post-acute care, Medicare, Advantage, nursing, home

The findings arrive as roughly 69 million people prepare to enter Open Enrollment for 2027 coverage, which runs from October 15 to December 7. The poll team gathered its data just after last year’s enrollment period by surveying Medicare enrollees aged 65 and older drawn from a nationally representative sample of older adults. The survey, conducted by NORC at the University of Chicago, was administered online and by phone in December 2025 and January 2026. The Medicare questions went to 1,796 community-dwelling U.S. adults aged 65 to 98 from the AmeriSpeak panel, with results weighted to reflect the population. A Michigan-focused analysis, funded by the Michigan Health Endowment Fund as part of the Michigan Poll on Healthy Aging, included 608 community-dwelling Michigan adults aged 65 to 93 and found no major differences from the national sample.

Perhaps the most telling number in the poll is this: 80 percent of respondents stuck with the same Medicare coverage they had the previous year. That pattern of inertia persists even though plan options, costs, and benefits often change from year to year, and even though the menu of available plans varies dramatically depending on where a person lives. Geoffrey Hoffman, an associate professor at the University of Michigan School of Nursing and an IHPI member who studies Medicare, said the data point to a strong need for older adults, particularly those dissatisfied with their current coverage, to take more time to thoroughly review their options. It is easy, he noted, to set coverage aside and forget about it, especially when someone likes their current plan and assumes it is the best available, but the number of choices and the tools for navigating them can be confusing, and there may be coverage that better suits a person’s needs and wallet.

Confidence, however, does not appear to be in short supply. Virtually all those surveyed, 92 percent, said they were somewhat or very confident about making decisions about their Medicare coverage. That self-assurance stands in contrast to how little time many devote to the decision and to the sources they rely on when they do look. Among those who did review what was available in their area, only 25 percent said the most important source they consulted was one offered by Medicare itself, either the plan-finding tool on the Medicare website or the Medicare hotline. Just 5 percent named a free local counselor, such as one from the federally funded State Health Insurance Assistance Program, known as SHIP, which operates in every state. By comparison, 26 percent said their most important source was an insurance broker, and 21 percent said it was a health plan website, sources that may carry commercial incentives.

Lianlian Lei, an assistant professor in the University of Michigan Medical School who also worked on the poll, has compared the decision to other major purchases. Just as someone would take time before buying a car or a major appliance, she noted, the same care should apply to Medicare options. The best choice depends on a person’s health conditions and goals, the doctors they want to see, the hospitals they prefer, and the medications their doctors have prescribed. She also pointed out that the best plan for one member of a couple may not be the best one for their partner, a reminder that household coverage decisions deserve individual scrutiny.

The poll also probed how many enrollees had heard about major policy changes that federal lawmakers and the Centers for Medicare and Medicaid Services had made for 2026. Awareness was modest across the board. The change generating the most recognition was lower prices for 10 high-cost drugs, a result of Medicare’s new authority to negotiate what it pays drugmakers for some prescription medications, but only 38 percent of all respondents had heard of it. The impact on any individual enrollee depends on the Part D prescription drug plan they choose, and fifteen more drugs added to the negotiation list for 2027 will be reflected in the drug coverage shown on the Medicare Plan Finder.

Even fewer enrollees knew about changes affecting their own wallets. Just 29 percent were aware of two 2026 changes that could increase their exposure to prescription drug costs: an increase in the deductible, the total amount they could be asked to pay before Medicare or their Medicare Advantage plan starts paying, and an increase in the cap on total annual drug costs. Only 15 percent had heard of a feature added during the 2026 enrollment cycle that lets users of the Medicare Plan Finder see which doctors and other health care professionals would be considered in network by a chosen Medicare Advantage plan. That information had been difficult to find in previous years, even though going to an out-of-network provider or hospital can be very costly.

When poll respondents were asked to choose from a list of factors that mattered most in their Medicare decisions, out-of-pocket costs topped the list, selected by 69 percent, followed closely by medication coverage at 63 percent and network coverage of health care providers at 62 percent. Jeffrey Kullgren, the poll’s director, who has studied how out-of-pocket costs influence health decisions, especially among people with chronic conditions, added a caution: just because a plan was available one year does not mean it will be available the next. Medicare Advantage and prescription drug plan options are changing across the country as insurance companies make business decisions about what they offer and where, which makes it especially important, he said, to check all options carefully every year.

The technical landscape of Medicare itself helps explain why the decision is so complex. Depending on where someone lives, options always include traditional Medicare, which is accepted by nearly all doctors and hospitals, and may include as many as 80 Medicare Advantage plans, each with its own networks. In some areas, a program called PACE is available to Medicare-eligible people who need nursing home-level care but want to remain at home. Optional Medigap plans can supplement traditional Medicare, although states vary in whether enrollees with major health issues can be charged more or denied outright if they want to buy a Medigap plan after moving from Medicare Advantage back to traditional Medicare. Medicare Advantage plans can offer benefits traditional Medicare cannot, such as transportation, food programs, and caregiver support, though some plans have trimmed these offerings in recent years. Part D prescription plans each carry their own formulary, deductible, and per-fill copay, and in 2027 Part D deductibles can range from zero to as high as 700 dollars.

One structural protection has changed the calculus for drug costs. Since 2025, a cap has limited the total amount any Medicare enrollee must pay out of pocket for prescriptions covered by Part D or Medicare Advantage, closing the so-called donut hole that formerly left some enrollees paying thousands more. That cap rises to 2,400 dollars in 2027, up from 2,100 dollars in 2026 and 2,000 dollars in 2025. Meanwhile, older adults face a barrage of marketing mail, phone calls, advertisements, and even free dinner information sessions every fall from insurance companies and from brokers who earn commissions based on how many people they sign up. Against that noise, free resources exist: the Medicare website and toll-free hotline offer information in multiple languages with interpreter and deaf and hard-of-hearing services, the Plan Finder lets users compare Medicare Advantage, Part D, and Medigap plans down to specific drugs and doctors, and SHIP counselors and programs such as Michigan’s MI Options call center, launched in summer 2025, provide help with no financial stake in the outcome. Yet NPHA data from 2024 showed that only 25 percent of people over 50 were familiar with SHIPs. For those who do switch to a Medicare Advantage plan and regret it, a second chance exists: they can change plans, or move to traditional Medicare, before March 31 after coverage begins, and other special enrollment periods may also apply.

Subject of Research: Medicare plan selection behavior and decision-making among older adults during Open Enrollment

Article Title: Many older adults make Medicare decisions quickly and most don’t change plans, poll finds

Article References: Many older adults make Medicare decisions quickly and most don’t change plans, poll finds. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: Medicare, Open Enrollment, Medicare Advantage, National Poll on Healthy Aging, University of Michigan, prescription drug costs, SHIP counselors, health insurance, older adults, Plan Finder, Part D, health policy

Selection was carried out by a panel composed of gerontological professionals and experienced editors, who evaluated candidates on the strength of their proposals for an in-depth story or series focused on aging. The winning pitches, which the fellows will produce during 2027, cover an unusually wide topical terrain: social isolation among older adults, the strains on the long-term care system, barriers to accessible health care, and the ways digital transformation is reshaping what it means to grow old in America. The breadth of the proposals reflects a recognition that aging is not a narrow medical subject but a lens through which economics, technology, climate, criminal justice, and family life can all be examined.

The individual projects illustrate that range in concrete terms. Zoe Beketova of The Xylom will investigate the cognitive consequences of growing old in isolation, using America’s aging prison population as a case study. Yvette Benavides of Texas Public Radio plans a series called Reading Together, exploring book clubs and healthy aging in San Antonio. Deborah Lynn Blumberg of the Jewish Telegraphic Agency will examine caregiving conflicts, religious rituals, and end-of-life care in a population she describes as getting older faster. Belinda Z. Burgos González of Public Health PR will report on how health, infrastructure, and social conditions shape the ability to age well in Puerto Rico, while Tina Charisma of the Roanoke Rambler will trace how digital transformation is changing everyday life across health care, government, transportation, and financial services.

Several fellows will focus on the intersection of aging and economic precarity. Sharon Donovan of Kentucky Health News will ask what it costs seniors and their family caregivers when home remains the preferred place to grow old. Max Erkiletian of SavingAdvice.com will investigate how predictive software is cutting off care in Medicare Advantage plans and how beneficiaries can win Medicare appeals, a topic that touches on the algorithmic tools increasingly used to authorize or deny medical services. Lorie Konish of CNBC will examine older adults caught in legal and legislative policy dilemmas and estate-planning challenges that threaten their ability to hold on to their homes and preserve family assets, with particular attention to low-income and racially diverse communities. Lara Nicholson of The Times-Picayune, The Advocate, and NOLA.com will report on senior housing and aging-in-place challenges in Louisiana’s densely populated Jefferson Parish.

Other projects extend the aging beat into environmental and intergenerational territory. Jordan Gass-Pooré of Inside Climate News will document the impacts of climate change on America’s aging farmers and ranchers, connecting demographic trends to the physical and economic risks of a warming countryside. Krys’tal Griffin of The News Journal and Delaware Online will explore how aging adults cope with the long-term care needs of their adult children, a reversal of the more familiar caregiving narrative. Amy Carlson Gustafson of MinnPost will chronicle how Minnesota’s older adults are embracing arts and culture and the health benefits that follow, while Alli Joseph of Salon.com will examine how America’s health care system has quietly shifted its most essential work to families under the framing that home is the new hospital.

Two fellows will take explicitly systemic views. Dawn Reiss, writing for Chicago Health and Caregiving Magazine, plans a series titled Closing the Age Gap in Health Care, asking how medical institutions and researchers can make health care more accessible, responsive, and effective for an aging population. Cari Shane of the USA Today Network will produce a series on needed changes in American culture, economics, and public health, including the medicalization of American society, cultural attitudes about aging, and how social and health systems could be reorganized for more widely affordable accessibility. Together, these projects demonstrate the editorial logic of the fellowship: rather than isolated features, the program aims to seed sustained, multi-part journalism that can shift public conversation about later life.

The new fellows will convene at the GSA 2026 Annual Scientific Meeting, scheduled for November 4 to 7 in National Harbor, Maryland. That gathering gives the journalists direct access to the latest peer-reviewed aging research and to approximately 4,000 expert attendees, including researchers, clinicians, educators, and policy specialists. The fellowship program will showcase research highlights from the meeting and other sources and will host discussions with veteran journalists about how to position aging stories in the current media environment, a practical concern at a time when attention economics and shrinking newsroom resources make specialized beats harder to sustain.

Leadership of the program is shared between Todd Kluss, GSA’s Director of Communications and Social Media, and Liz Seegert, an independent age-beat journalist who also serves as program coordinator for the fellowship’s media partner, the Journalists Network on Generations. Paul Kleyman, program co-founder and national coordinator of the Journalists Network on Generations, serves as senior advisor and editorial consultant. This structure pairs institutional scientific expertise with working journalistic experience, a design intended to help fellows translate gerontological research into accurate, compelling narratives for general audiences.

Financial support for the program comes from a coalition of foundations with long-standing interests in aging and health care quality, including the Silver Century Foundation, The Commonwealth Fund, The John A. Hartford Foundation, the National Institute for Health Care Management Foundation, and the Health Foundation for Western and Central New York, along with the Aging and Gerontology Programs at the University of Maryland, Baltimore County. Individual donations from Betty F. Malks and John Migliaccio established a fellowship honoring the memory of Elizabeth Podnieks, an elder justice advocate and founder of World Elder Abuse Awareness Day. In addition to the new cohort, continuing fellowship grants will allow several previous fellows to participate in the program and attend the GSA meeting, extending the investment made in earlier classes.

The program’s long-term output is substantial. A continuously updated list of more than 850 stories generated by the program’s alumni is available on GSA’s website, a body of work that has contributed to public understanding of Social Security, Medicare, caregiving, elder abuse, housing, and health disparities. The Gerontological Society of America, founded in 1945, is the oldest and largest interdisciplinary organization focused on aging, serving more than 6,000 members in over 50 countries and housing the National Academy on an Aging Society and the National Center to Reframe Aging. The Journalists Network on Generations, founded in 1993 and based in San Francisco, links more than 1,000 journalists, authors, and producers covering aging and publishes Generations Beat Online News. As the 2027 projects move from proposal to publication, the seventeenth class of fellows will add to that archive, testing whether deeply reported stories about isolation, care, climate, and technology can reshape how a rapidly aging nation understands its own future.

Subject of Research: A journalism fellowship program supporting in-depth media coverage of aging and gerontology

Article Title: 15 Journalists from across U.S. awarded aging-focused fellowships

Article References: 15 Journalists from across U.S. awarded aging-focused fellowships. (n.d.). Original publication

Image Credits: AI Generated

DOI: Not provided

Keywords: aging, journalism fellowships, Gerontological Society of America, Journalists Network on Generations, long-term care, social isolation, health care access, caregiving, Medicare Advantage, elder justice, senior housing, digital transformation