Medicare
Prescription Drugs
The First-Ever Government Negotiation Process For Drugs Has Finished, But The Politics Are Ongoing
This post for Health Affairs Forefront examines how the results of the first-ever Medicare drug price negotiations will generate savings for the government and for Medicare beneficiaries, and how candidates’ views on the issue could play a role in the upcoming elections and in the future of government negotiation.
New & Noteworthy
Health Policy 101: Medicare
Medicare provides health insurance coverage to 66 million people. It covers a comprehensive set of health care services, including hospitalizations, physician visits, and prescription drugs, along with post-acute care, skilled nursing facility care, home health care, hospice, and preventive services.Medicare Advantage Enrollees Account for a Rising Share of Inpatient Hospital Days
This analysis examines the recent growth of Medicare Advantage as a share of hospital inpatient days. Medicare Advantage rose from 13% to 23% of all inpatient days from 2015 to 2022, although there was wide variation among hospitals.1 in 4 Medicare Beneficiaries with Obesity or Overweight Could Be Eligible for Coverage of Wegovy
KFF finds that 3.6 million people with Medicare could be eligible for coverage of Wegovy now that the FDA has approved the use of the anti-obesity drug to reduce the risk of heart attacks and stroke in certain patients.What to Know About Medicare Part D Premiums
Several provisions in the Inflation Reduction Act are likely to shape Medicare Part D premiums for 2025. We explain how and why premiums might change. Actual premiums will not be known until September.
Medicare Advantage
Medicare Advantage Plans Denied a Larger Share of Prior Authorization Requests in 2022
KFF analysis of prior authorization trends found that Medicare Advantage plans are denying a higher share of prior authorization requests now than they have in recent years.
Plans denied 3.4 million prior authorization requests for health care services in whole or in part in 2022, or 7.4% of the 46.2 million requests submitted on behalf of enrollees that year. That compares to 5.7% in 2019, 5.6% in 2020 and 5.8% in 2021.
Plans denied 3.4 million prior authorization requests for health care services in whole or in part in 2022, or 7.4% of the 46.2 million requests submitted on behalf of enrollees that year. That compares to 5.7% in 2019, 5.6% in 2020 and 5.8% in 2021.
Data Visualization
The Facts About Medicare Spending
This interactive provides the facts on Medicare spending. Medicare, which serves 67 million people and accounts for 12 percent of the federal budget and 21 percent of national health spending, is often the focus of discussions about health expenditures, health care affordability and the sustainability of federal health programs.
Explore data on enrollment growth, Medicare spending trends overall and per person, growth in Medicare spending relative to private insurance, spending on benefits and Medicare Advantage, Part A trust fund solvency challenges, and growth in out-of-pocket spending by beneficiaries.
Related: FAQs on Medicare Financing and Trust Fund Solvency
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Marketing Medicare
Marketing Private Medicare Plans
Every Medicare open enrollment season, health insurers, brokers and other third parties use a blitz of TV ads to attract enrollees to Medicare Advantage plans from among the 65 million people with Medicare. We watched more than a thousand ads and conducted focus groups to better understand the marketing effort and its impact on beneficiaries. Learn more about this project at the links below.
View the TV Ad Analysis
View the Focus Group Report
View the TV Ad Analysis
View the Focus Group Report
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