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Medicare beneficiaries will have 32 Medicare Advantage plans with prescription drug coverage available to choose from, on average, in 2026.
This analysis finds that CMS’s proposed cut to Medicare reimbursement for 340B drugs, and accompanying increase for other outpatient services, would reduce revenues among safety-net hospitals while increasing revenues among for-profit hospitals.
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 brief provides the most recent data on the extent to which non-pediatric physicians are opting out of Medicare, by specialty and by state.
This brief examines the final CMS regulations governing prior authorization in Medicare Advantage, Marketplace, Medicaid, and other plans, how they might address some current consumer concerns, and some issues that remain.
Higher market concentration in Medicare Advantage insurance markets may lower the incentive for insurers to compete for potential enrollees by making plans more appealing through more comprehensive benefits or lower costs.
Taken together, if approved, these proposed budget cuts and other changes would fundamentally alter the nation’s HIV response which, along with the many other changes being proposed at HHS, does not bode well for making further gains in the fight against HIV.
This brief examines the share of Medicare beneficiaries who reviewed their coverage and compared plans during the open enrollment period for 2022 (that takes place in the Fall of 2021), and who made use of Medicare’s official information resources, as well as variations by demographic groups. Overall, nearly 7 in 10 Medicare beneficiaries did not compare their own source of Medicare coverage with other Medicare options offered in their area.
As the start of 2024, many issues are at play that will affect Medicaid coverage, financing, and access. This issue brief provides context for these Medicaid issues and highlights key issues to watch in the year ahead.
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