Are the Tradeoffs from Prior Authorization Worth It?
In his latest column, President and CEO Dr. Drew Altman asks if prior authorization review could be eliminated entirely, discussing how it might be done and the tradeoffs.
View the Latest: Administrative Costs
Filter
-
-
A Look at the Intersection of SNAP and Medicaid as States Implement Medicaid Work Requirements
Issue BriefThis brief describes the intersection between Medicaid and SNAP and discusses how information from SNAP may be leveraged by states when implementing the new Medicaid work requirements.
-
Challenges with Implementing Work Requirements: Findings from a Survey of State Medicaid Programs
Issue BriefTo better understand how states are preparing for Medicaid work requirements, states were asked to discuss anticipated challenges to implementing work requirements by the end of 2026, including related system changes and data matching.
-
The Semi-Sad State of Consumer Protection In Health Care
From Drew AltmanIn this column, KFF President and CEO Drew Altman explores the state of consumer protections in health care and explains why, even with consumer frustration clear, Congress is unlikely to pursue major new health insurance protections but there could be some modest steps.
-
Medicare Spent an Average of 27% More on People Who Switched from Medicare Advantage to Traditional Medicare Compared to Those Who Were Only in Traditional Medicare
News ReleaseA new KFF analysis finds higher Medicare spending among people who switched from Medicare Advantage to traditional Medicare than for similar beneficiaries who were in traditional Medicare all along.
-
Medicare Spending was 27% More for People who Disenrolled from Medicare Advantage than for Similar People in Traditional Medicare
Issue BriefThis analysis looks at traditional Medicare spending among people who choose to disenroll from Medicare Advantage and obtain coverage under traditional Medicare during the annual Medicare open enrollment period. It compares their traditional Medicare spending (Parts A and B) in the year following disenrollment to similar people who were continuously covered by traditional Medicare, using data from the Medicare Beneficiary Summary File (MBSF) for 2021 and 2022.
-
What to Know About Medicare Coverage of Telehealth
Issue BriefMany pandemic-era flexibilities around Medicare coverage of telehealth are due to expire in December 2024. There is bipartisan support for proposed legislation to extend these provisions for another two years, and Congress is weighing the potential benefits, risks, and costs of permanently expanding Medicare coverage of telehealth services. These FAQs provide answers to key questions about the current scope of Medicare telehealth coverage, including both temporary and permanent changes adopted through legislation and regulation, and policy considerations that lie ahead.
-
The CBO Report That Didn’t Roar
From Drew AltmanIn his latest column, KFF President and CEO Drew Altman discusses a recent Congressional Budget Office (CBO) estimate that the Centers for Medicare and Medicaid Innovation (CMMI)'s payment and delivery demonstrations have cost Medicare money, and what it means for the future of value-based payment.
-
How Do Facility Fees Contribute To Rising Emergency Department Costs?
Issue BriefWith the high costs of emergency department visits of significant importance to consumers and policymakers, this analysis examines claims data from privately insured individuals with large employer health plans, to examine the role that facility fees play in rising cost of emergency care.
-
Medicare Advantage Insurers Report Much Higher Gross Margins Per Enrollee Than Insurers in Other Markets
News ReleaseA new analysis of health insurers’ 2021 financial data shows that insurers continue to report much higher gross margins per enrollee in the Medicare Advantage market than in other health insurance markets. The analysis examines insurers’ financial data in the Medicare Advantage, Medicaid managed care, individual (non-group), and fully insured group (employer) markets.