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KFF designs, conducts and analyzes original public opinion and survey research on Americans’ attitudes, knowledge, and experiences with the health care system to help amplify the public’s voice in major national debates.
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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.
This analysis builds on previous KFF work by using Medicaid claims data for 2016-2019 to explore how prescriptions for opioids used to treat pain and those used to treat OUD or rapidly reverse overdose changed across states and Medicaid enrollee demographic groups over time.
In its role as a public program and the single largest payer of behavioral health services in the country, Medicaid is particularly well positioned to implement policy to improve the delivery, quality, and effectiveness of behavioral health services. Our analysis finds that 7.3 percent of Medicaid enrollees ages 12 to 64 had at least one clinically-identified substance use disorder in 2019, but this is likely an undercount, as other research suggests that prevalence is at…
Concerns about youth mental health and access to care continues to increase. Schools can be an easy access point for behavioral health services and Medicaid provides significant financing for the delivery of these services in schools. In this analysis, we explore the strategies state Medicaid programs are taking to promote and improve access to school-based behavioral health services, and how recent policies call on Medicaid to expand access to care for youth, particularly in schools.
This brief presents findings from a survey and roundtable discussion of Medicaid managed care plans about the role they may play in the unwinding of the pandemic-era continuous enrollment provision.
This analysis examines transparency data currently shared by hospitals to comply with federal law and finds that they are messy, inconsistent and confusing, making it challenging if not impossible for patients or researchers to use them to compare prices. Many of these shortcomings stem from a lack of specificity in the requirements for what hospitals must report.
This analysis of HealthCare.gov Marketplace insurers' transparency data finds that 17% of in-network claims were denied in 2021, with denial rates varying widely across insurers. Consumers appealed less than two-tenths of 1% of denied in-network claims.
This brief provides an overview of the major health-related COVID-19 federal emergency declarations that have been made since early on in the pandemic, summarizes the flexibilities triggered by each, and identifies the implications for their ending, related to coverage, costs, and payment for COVID-19 testing, treatments, and vaccines; Medicaid coverage and federal match rates; telehealth; access to medical countermeasures through FDA emergency use authorization (EUA); and other Medicaid, Medicare and private health insurance flexibilities.
This brief examines national and state-level data on enrollment and spending for Medicare-Medicaid enrollees using the 2019 and 2020 Medicare Beneficiary Summary Files and the 2019 Transformed Medicaid Statistical Information System (T-MSIS). Spending data for Medicare includes beneficiaries in traditional Medicare only, since spending data for beneficiaries enrolled in Medicare Advantage plans are unavailable. State-level data on Medicare-Medicaid enrollment and spending are available through KFF’s State Health Facts.
This brief examines the demographic, socioeconomic, and health characteristics of Medicare-Medicaid enrollees using the 2020 Medicare Current Beneficiary Survey. It highlights the diversity within the Medicare-Medicaid population and how Medicare-Medicaid enrollees differ from all other Medicare beneficiaries.
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