Medicare Advantage Enrollment and Access to Kidney Transplant After the 21st Century Cures Act.

Medicare Advantage beneficiaries with end-stage kidney disease had 29% lower kidney transplant rates than traditional Medicare beneficiaries in the first three years after the 21st Century Cures Act.

• Why it matters: Access to kidney transplant is crucial for improving survival and quality of life in patients with kidney failure, yet limited evidence exists on how the expansion of Medicare Advantage affects transplant access.
• What they did: A retrospective cohort study analyzed 630,848 Medicare beneficiaries aged 18 to 74 with ESKD from 2021 to 2023, comparing transplant and wait-listing rates between Medicare Advantage and traditional Medicare, adjusting for multiple demographic and regional factors.
• The result: Medicare Advantage enrollees had significantly lower transplant (aRR, 0.71) and wait-listing (aRR, 0.77) rates than traditional Medicare beneficiaries, indicating potential disparities that may require policy oversight.