March 21 Web Event: Unpacking the Controversy Over Medicare Advantage March 21, 2023 Event Medicare Advantage is the rapidly growing private plan alternative to traditional Medicare that provides coverage to approximately half of Medicare beneficiaries. Controversy has arisen over a Biden Administration proposal for changes to payments to insurers for the coming year, including how the health risk of enrollees is captured, as well…
FAQs on Health Spending, the Federal Budget, and Budget Enforcement Tools March 20, 2023 Issue Brief As some policymakers in Washington are pushing to reduce the federal deficit and debt, this brief provides a concise explanation of federal spending for domestic and global health programs and services, which could be part of any conversation about curbing federal spending. These FAQs answer basic questions about health spending and the federal budget and budget enforcement tools, including the debt limit and sequestration.
As Debate Heats Up in Washington Over Possible Entitlement Cuts, A New KFF Analysis Details the 30% of Federal Spending That Goes to Health Care Programs March 1, 2023 News Release As some policymakers in Washington are pushing to reduce the federal deficit and debt, a new KFF resource provides a concise explanation of federal spending for domestic and global health programs and services, which could be part of any conversation about curbing federal spending. Federal spending on health programs and…
Medicare Advantage Insurers Report Much Higher Gross Margins Per Enrollee Than Insurers in Other Markets February 28, 2023 News Release A new analysis of health insurers’ 2021 financial data shows that insurers continue to report much higher gross margins per enrollee in the Medicare Advantage market than in other health insurance markets. The analysis examines insurers’ financial data in the Medicare Advantage, Medicaid managed care, individual (non-group), and fully insured…
Health Insurer Financial Performance in 2021 February 28, 2023 Issue Brief Using health insurer financial data for 2021, we find that Medicare Advantage insurers reported gross margins that were at least twice as high as those reported by insurers in the individual/non-group, fully-insured group/employer, and Medicaid managed care markets. The four markets report similar simple medical-loss-ratios.
CMS Prior Authorization Proposal Aims to Streamline the Process and Improve Transparency February 21, 2023 Issue Brief This brief explains a new proposed federal regulation aimed at reducing administrative hassles involved in obtaining prior authorization for care and sets out key policy questions, including how the proposal could impact the patient experience and data privacy.
Is the Biden Administration Proposing Cuts to Medicare Advantage? February 17, 2023 Blog Recent announcements by the Administration to improve the accuracy of payments and improve program integrity of Medicare Advantage are unlikely to have a major impact on the program, the insurance industry or beneficiaries, given relatively generous payments to plans and the robustness of the market for private Medicare plans.
The End of the COVID-19 Public Health Emergency: Details on Health Coverage and Access February 3, 2023 Blog This post provides an overview of how health care coverage and access will and won’t change when the public health emergency ends on May 11, including a discussion of COVID-19 vaccines, tests, and treatments, and telemedicine.
Medicare Advantage Plans Denied 2 Million Prior Authorization Requests in 2021, About 6% of Such Requests February 2, 2023 News Release Medicare Advantage plans denied two million prior authorization requests for health care services in whole or in part in 2021, or about six percent of the 35 million requests submitted on behalf of enrollees that year, a new KFF analysis finds. Prior authorization is intended to ensure that health care…