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  • Preventing Chronic Disease: The New Public Health

    Event Date:
    Event

    There is a groundswell of activity in local communities to support healthier lifestyles and help people make long-lasting and sustainable changes that can reduce their risk for chronic diseases. A number of provisions in the health reform law are aimed directly at improving population health by addressing conditions where Americans live, learn, work, and play. Public health agencies across the nation are involved in promoting healthy life styles in their communities and the U.S. Department…

  • Probing the Power and Practices of Pharmacy Benefit Managers

    Event Date:
    Event

    Pharmacy benefit managers (PBMs) are increasingly scrutinized intermediaries in the U.S. health care system, negotiating discounts on prescription medications for health insurers and employers while collecting rebates from drugmakers. On June 14, two experts joined KFF’s The Health Wonk Shop and series moderator Larry Levitt in a 45-minute discussion about the power and practices of PBMs.

  • Coverage of Dental Services in Traditional Medicare

    Issue Brief

    In Medicare Physician Fee Schedule Final Rules from recent years, the administration made changes to Medicare payment policies for certain dental services, in addition to other payment and policy changes. The 2023 rule clarified CMS’s interpretation of when medically necessary dental services can be covered and codified certain payment policies, and the 2023, 2024, and 2025 rules define new clinical scenarios for which Medicare payment can be made for dental services. This brief describes current…

  • What Might a Repeal of the Affordable Care Act Mean for Medicare?

    News Release

    As Republican policymakers consider how to repeal and replace the Affordable Care Act (ACA), they are likely to face a number of decisions about whether to retain any of the law’s changes to Medicare. Repealing the ACA has potential implications for Medicare spending, beneficiaries, and other stakeholders, according to a new Kaiser Family Foundation brief. A full repeal of the ACA would undo all of the law’s changes to Medicare and would increase Medicare spending,…

  • What Percent of New Medicare Beneficiaries Are Enrolling in Medicare Advantage?

    Issue Brief

    The analysis examines enrollment in Medicare Advantage plans during beneficiaries’ first year on Medicare and finds that less than one-third or 29% enrolled in these private health plans, including HMOs or PPOs. The majority of people new to Medicare are choosing traditional Medicare in the year they first go on Medicare. The study looks at how these findings vary across age, Medicaid status, states, and counties.

  • Financial Performance of Medicare Advantage, Individual, and Group Health Insurance Markets

    Issue Brief

    Three key private health insurance markets -- Medicare Advantage, the individual market and the fully-insured group market -- appear to be financially healthy and attractive to insurers. The private Medicare Advantage market generates significantly larger gross margins per person than the individual market or fully-insured market. The future of these markets has become a focus for policymakers amid the debate over Medicare for All.