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  • The Semi-Sad State of Consumer Protection In Health Care

    From Drew Altman

    In 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 Spending was 27% More for People who Disenrolled from Medicare Advantage than for Similar People in Traditional Medicare

    Issue Brief

    This 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 Brief

    Many 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.

  • Health Insurer Financial Performance in 2023

    Issue Brief

    Using health insurer financial data for 2023, we find that in 2023, per enrollee gross margins were highest in the Medicare Advantage market, and medical loss ratios were lowest in the individual insurance market. Across most markets, gross margins have been relatively stable in recent years.

  • The CBO Report That Didn’t Roar

    From Drew Altman

    In 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 Brief

    With 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 Release

    A 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.

  • Distribution of CARES Act Funding Among Hospitals

    Issue Brief

    This brief analyzes the distribution of $50 billion in CARES Act funding for providers and shows that the distribution formula selected by the Department of Health and Human Services favored hospitals with a relatively high share of revenue from private insurance. Hospitals that see a smaller share of patients with private insurance and instead see more patients with Medicare or Medicaid received less funding per hospital bed.