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This issue brief describes how Medicaid home care operates—including who is eligible and the systems in place to promote program integrity in its delivery—and the challenges of using new CMS data to identify unusual billing patterns or potential fraud in the program.
Opioid overdose deaths fell sharply from 2023 to 2024 (79,358 to 54,045), driven largely by decreases in fentanyl-involved deaths. Even after these declines, deaths remained above 2019, the year before opioid deaths increased sharply during the pandemic.
Suicide deaths fell slightly from their peak of 49,476 deaths in 2022 to 48,824 deaths in 2024, but trends by suicide method diverged: suicides by other means declined while firearm suicides reached their highest level and accounted for 57% of all suicides (up from 50% in 2014).
Alcohol deaths increased gradually before the pandemic, jumped in 2020 and 2021, and have fallen somewhat since then. Even after these declines, deaths remained above 2019, the year before the pandemic.
This analysis of trends in health insurers’ financial data shows that insurers’ gross margins per enrollee dipped slightly in 2024 across four markets, remaining highest in the Medicare Advantage market, followed by the individual (non-group) market, the fully insured group (employer) market, and Medicaid managed care. The analysis also examines insurers’ medical-loss ratios across the four markets.
On February 14, 2026, CMS released a dataset with provider-level spending data that the agency suggests could be used to identify unusual billing patterns for specific services, states, or providers. This policy watch describes what the data include, what they exclude, and how they could potentially lead to mistaken conclusions given the limitations of the data.
This brief describes the Managed Care Program Annual Report (MCPAR), a relatively new, comprehensive report on state Medicaid managed care programs that includes plan-level data. It is aimed at improving state and federal managed care program monitoring, oversight, and transparency.
The PERM program measures improper payments in Medicaid through cyclical audits of state Medicaid programs. This brief explains the PERM program and its three component error rates as well as upcoming changes to PERM and possible state impacts.
This brief provides an overview of the role of PBMs in managing pharmacy benefits, discusses federal efforts to reform certain PBM business practices, and explains the estimated federal budgetary impact of the recently enacted legislation, which would be a reduction in the federal deficit of $2.1 billion over 10 years, according to CBO.
This issue brief explains why it can be misleading to compare the first year of Rural Health Transformation Program allocations with estimated Medicaid cuts, which will be implemented on a gradual basis and not fully take effect until 2027, after the rural health fund is exhausted.
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