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.
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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.
More than half of U.S. health spending went toward hospital and physician services in 2018. Learn more about the breakdown of the nation's health spending in the Peterson-KFF Health System Tracker.
The AI revolution is already here — but what does it mean for patients, clinicians, and health care industry leaders? Eric Larsen, veteran health care strategist and longtime advisor to CEOs across the industry, joins host Chip Kahn for a discussion about why the U.S. health care industry is uniquely exposed to AI-driven disruption and the implications for patients, clinicians, and the health care workforce. Listen to Larsen's take on "the most consequential technology humanity’s…
When minutes matter for a patient’s care, what is AI’s role in clinical practice? Elad Walach, co-founder and CEO of Aidoc — a company with a comprehensive AI health care platform that analyzes real-time images and flags time-sensitive findings — shares his perspective on AI’s transformative power in dodging diagnostic error, improving access to care, and ensuring care quality in busy clinical settings.
This issue brief raises three key questions for consideration if using Medicaid to wrap around private coverage is going to be considered as an alternative to the ACA's Medicaid expansion under the BCRA. We draw on existing information about state Medicaid premium assistance programs to date, the administrative complexity involved, and the financing implications of premium assistance programs.
This issue brief draws on features of the various existing Medicaid home and community-based services (HCBS) programs to identify key policy questions raised by initiatives to streamline Medicaid HCBS, ameliorate institutional bias, and improve administrative simplification.
A 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 spent an average of 27% more on such beneficiaries, according to the analysis, which examined health costs in traditional Medicare for both groups in the year following the switch, after adjusting for differences in health status and other characteristics. This amounts to a difference of…
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.
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.
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. In 2021, Medicare Advantage insurers reported gross margins averaging $1,730 per enrollee, at least double the margins reported by insurers in the…
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