Final Prior Authorization Rules Look to Streamline the Process, but Issues Remain May 2, 2024 Issue Brief This brief examines the final CMS regulations governing prior authorization in Medicare Advantage, Marketplace, Medicaid, and other plans, how they might address some current consumer concerns, and some issues that remain.
Coverage of Sexual and Reproductive Health Services in Medicare April 30, 2024 Issue Brief This brief describes Medicare coverage of sexual and reproductive health services, including contraception, and compares that coverage with private insurance plans and Medicaid. These benefits are particularly relevant to nearly 1 million women of reproductive age (20-49) who are eligible for Medicare due to having a long-term disability.
10 Key Facts About Women with Medicare April 30, 2024 Issue Brief This brief examines 10 key facts about women with Medicare and presents new statistics on the health, economic and functional status of women with Medicare.
Five Facts About Older Adults’ Health Care Experiences by Race and Ethnicity April 29, 2024 Issue Brief This analysis highlights key findings about the health care experiences of older adults (ages 65 and older) based on KFF’s 2023 Survey on Racism, Discrimination, and Health, including variations by race and ethnicity.
An Estimated 1 in 4 Medicare Beneficiaries With Obesity or Overweight Could Be Eligible for Medicare Coverage of Wegovy, an Anti-Obesity Drug, to Reduce Heart Risk April 24, 2024 News Release In a new analysis, KFF finds that 3.6 million people with Medicare could be eligible for coverage of Wegovy (semaglutide) now that the Food and Drug Administration has approved the use of the anti-obesity drug to reduce the risk of heart attacks and stroke in certain patients. This change potentially…
A New Use for Wegovy Opens the Door to Medicare Coverage for Millions of People with Obesity April 24, 2024 Issue Brief The FDA recently approved a new use for Wegovy, the blockbuster anti-obesity drug, to reduce the risk of heart attacks and stroke in people with cardiovascular disease who are overweight or obese – a decision that opens the door to Medicare coverage of Wegovy, which is prohibited by law from covering drugs used for obesity. This brief analyses how many Medicare beneficiaries could be eligible for the new use of Wegovy and the potential impact on Medicare spending.
The Vast Majority of Nursing Facilities Will Need to Hire More Staff to Comply with the Final Federal Rule When Fully Implemented, Unless They Qualify for an Exemption April 22, 2024 News Release Based on a new KFF analysis, fewer than 1 in 5 (19%) nursing facilities currently meet the minimum staffing standards set out in the final requirements of the federal rule released today by the Centers for Medicare and Medicaid Services (CMS). CMS adopted staffing standards that are similar to the…
With Current Staffing Levels, About 1 in 5 Nursing Facilities Would Meet Fully-Implemented Minimum Staffing Standards in the Final Rule April 22, 2024 Blog This analysis uses the most recently-available data to examine the percentage of nursing facilities that currently meet the minimum staffing requirements in the final rule.
Retiree Health Benefits: Going, Going, Nearly Gone? April 12, 2024 Issue Brief This data note analyzes five national surveys to assess trends in retiree health coverage among people ages 65 and older. These five surveys produce somewhat different estimates of retiree health coverage, but together paint a clear picture: the share of Medicare-age adults with employer- or union-sponsored retiree health coverage has been shrinking and appears to be on the way to extinction.
Gaps in Medicare Advantage Data Remain Despite CMS Actions to Increase Transparency April 10, 2024 Issue Brief The Centers for Medicare and Medicaid Services has recently taken actions to increase transparency in Medicare Advantage, however substantial data gaps remain that limit the ability of policymakers and researchers to conduct oversight and assess the program’s performance, and for Medicare beneficiaries to compare Medicare Advantage plans offered in their area.