Program on Medicare Policy Archives

Many Medicare Part D Stand-Alone Drug Plan Enrollees Will See Modest Premium Increases for 2027, But Others Could Pay Much More If They Don’t Switch Plans

Oct 2, 2026

Issue Brief

This brief analyzes the Medicare Part D stand-alone prescription drug plan (PDP) market for 2027. The analysis shows that there will be a modest reduction in the number of PDPs for 2027, along with modest premium increases less than $10 per month for many enrollees, but much larger monthly premium increases of $50 or more for others if they don’t change plans.

The Average Medicare Beneficiary has 28 Medicare Advantage Prescription Drug Plan Options for 2027

Oct 1, 2026

Issue Brief

The average Medicare beneficiary will have 28 Medicare Advantage prescription drug (MA_PD) plans available for general enrollment in 2027. The number of plans varies widely across states.

Prior Authorization Metrics Provide New Insights into Insurer Practices, but Gaps Remain

Aug 13, 2026

Issue Brief

This analysis of available 2025 prior authorization data finds insurers denied at least 1 in 8 standard requests for prior authorization across three insurance markets: Medicare Advantage, Medicaid managed care, and the federally facilitated ACA Marketplaces. Denial rates varied wide segments by insurer. The analysis highlights limitations of the data and challenges for consumers interpreting it.

Medicare Will Spend More Than $13 Billion on the Medicare Advantage Quality Bonus Program in 2026

Aug 12, 2026

Issue Brief

The Medicare program will spend at least $13 billion on the Medicare Advantage quality bonus program in 2026, as 68% of Medicare Advantage enrollees are in a plan that qualifies for higher payments under the program.

Digital Health Tools and Technologies: An Overview of CMS’ Recent Efforts to Expand Their Use in Medicare

Jul 7, 2026

Issue Brief

As an increasing share of older adults have adopted digital health technologies over the past several years, and with most expressing interest in using them to manage their health care, the Centers for Medicare & Medicaid Services (CMS) has introduced several initiatives to expand the use of digital health technologies in Medicare. This brief summarizes these initiatives and draws on data from various surveys, including KFF Tracking Polls from September 2025 and March 2026, to…

Medicare Advantage Insurers Deny Prior Authorization Requests for Post Acute Care at Substantially Higher Rates Than the Overall Denial Rate

Jul 6, 2026

Policy Watch

Two recent reports find that Medicare Advantage organizations deny prior authorization requests for long-term care hospital, inpatient rehabilitation hospital, and skilled nursing facility stays at higher rates than requests overall. When these decisions are appealed, they are frequently overturned, particularly for skilled nursing facility stays. This may cause delays for Medicare beneficiaries who are particularly vulnerable or have high care needs.

Decoding Medicare Advantage Coding Intensity

Jul 1, 2026

Issue Brief

Federal payments to Medicare Advantage plans, and adjustments for health status, have come under increased scrutiny. This brief answers key questions about coding intensity, recent steps taken by CMS, the effects on beneficiaries, and other proposals to improve payment accuracy.

Nearly Four Million Medicare Beneficiaries Could Be Eligible for the Temporary Medicare GLP-1 Bridge Program Covering These Drugs for Weight Loss

Jun 29, 2026

Issue Brief

This news release highlights that a KFF analysis finds that 3.8 million Medicare beneficiaries met the criteria to be eligible for the new Medicare GLP-1 Bridge, based on claims data from 2023. The temporary program will provide coverage of three GLP-1 drugs used for weight reduction and weight management to eligible Medicare beneficiaries.

Nearly Four Million Medicare Beneficiaries Met the Eligibility Criteria in 2023 for the Medicare GLP-1 Bridge

Jun 29, 2026

Issue Brief

Medicare has launched a temporary program covering GLP-1s for obesity for people with Medicare, known as the Medicare GLP-1 Bridge. This analysis estimates the number of Medicare Part D enrollees who could potentially qualify for the Bridge program by meeting all of the eligibility criteria, based on claims data from 2023.

Key Facts About Medicare Spending Trends and Projections from the 2026 Medicare Trustees Report

Jun 24, 2026

Issue Brief

This brief provides an overview of key trends in Medicare spending and spending growth, as well as the impact of these trends on out-of-pocket costs for Medicare beneficiaries and Medicare program solvency, as projected by the Medicare Trustees in the 2026 Trustees Report.

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