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  • Medicare’s Coverage Decision for the New Alzheimer’s Drug and Why It Matters

    Policy Watch

    This policy watch discusses the implications of Medicare's preliminary National Coverage Determination for the new Alzheimer's drug, Aduhelm, on the 2022 Medicare Part B premium and the possibility of an adjustment based on the coverage decision. The piece also discusses the implications for Medicare spending and the connection to ongoing policy discussions around prescription drug proposals in the Build Back Better Act.

  • Why We Are Stuck with Prior Authorization Review

    From Drew Altman

    Prior authorization review frustrates patients and physicians, but we likely can’t just eliminate it. In his new column, President and CEO Dr. Drew Altman discusses why, and why the focus is now instead on “doing it smarter.” Altman writes: “A proposal to eliminate prior authorization altogether could be the single most tangible and popular health reform idea a candidate could make. But, in our fragmented health system, with no great way to control costs or…

  • Mental Health and Substance Use Disorder Coverage in Medicare Advantage Plans

    Issue Brief

    This brief describes the scope of mental health and substance use disorder benefits in Medicare Advantage plans, including extra benefits, cost sharing, and prior authorization and referral requirements, based on an analysis of the Centers for Medicare and Medicaid Services (CMS) Medicare Advantage plan benefit and enrollment files for 2022.

  • 5 Key Facts About Medicaid Coverage for Adults with Chronic Conditions

    Issue Brief

    Nearly three in four adults enrolled in Medicaid have one or more chronic conditions. Medicaid spending doubles for adults with 1-2 chronic conditions and quadruples for those with 3 or more chronic conditions. Low or no out-of-pocket costs for prescription medications in the Medicaid program help adults with chronic conditions avoid cost-related rationing or delays in prescription access. Uninsured adults were 2.5 times more likely than Medicaid-enrolled or privately insured adults to report skipping or…

  • 2023 Employer Health Benefits Chart Pack

    Feature

    This slideshow captures key data from the 2023 KFF Employer Health Benefits Survey survey, providing a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing, abortion coverage, offer rates, wellness programs, and other employer practices.

  • 7 in 10 Medicare Beneficiaries Report That They Did Not Compare Their Coverage Options During a Recent Open Enrollment Period

    News Release

    With the Medicare open enrollment period set to begin October 15, a new KFF analysis finds that 7 in 10 beneficiaries (71%) say that they didn’t compare their coverage options during a recent open enrollment season. Twenty-nine percent said they did compare Medicare plans. But not shopping around can have a big impact on enrollees’ coverage and costs. The Centers for Medicare & Medicaid Services (CMS) recommends that beneficiaries review and compare Medicare plans each…

  • Updated Health Spending Explorer Features the Latest National Data

    News Release

    New 2020 data on U.S. health spending are now available on the Health Spending Explorer, an interactive tool that allows users to explore trends in health expenditures by federal and local governments, insurers, service providers, and individuals. The data, which span from 1960 to 2020, are based on the just-released national health spending report from the federal government. The new data reflect the country experiencing a global pandemic which impacted health care spending and policymaking…

  • Section 1115 Waiver Watch: A Look at the Use of Contingency Management to Address Stimulant Use Disorder

    Policy Watch

    Contingency management is an evidence-based psychosocial intervention that uses motivational incentives, such as vouchers or gift cards, to encourage recovery behaviors like stimulant abstinence and treatment session (e.g., cognitive behavioral therapy, group therapy) attendance. The Biden administration has approved five state contingency management waivers (California, Delaware, Hawaii, Montana, and Washington); two additional state contingency management requests are currently pending federal review.