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  • Medicaid Health Homes: A Profile of Newer Programs

    Issue Brief

    Under the ACA, states have a new Medicaid option to establish "health homes" designed to improve care coordination and integration and reduce costs for beneficiaries with chronic conditions. Thus far, 15 states have implemented health home programs. Following on a 2012 brief profiling Medicaid health home programs in the first six states to adopt the option, this brief describes the health home programs in the nine states that have implemented them since that time, and…

  • The Out-of-Pocket Cost Burden for Specialty Drugs in Medicare Part D in 2019

    Issue Brief

    Medicare Part D has helped to make prescription drugs more affordable for people with Medicare, yet many beneficiaries continue to face high out-of-pocket costs for their medications. Specialty tier drugs are a particular concern for Part D enrollees in this context. This analysis draws on data from Medicare’s Plan Finder website to calculate expected annual 2019 out-of-pocket costs for 30 specialty tier drugs used to treat four health conditions—cancer, hepatitis C, multiple sclerosis, and rheumatoid…

  • Medicare Part D Enrollees with Serious Health Conditions Can Face Thousands of Dollars in Out-of-Pocket Costs Annually for Specialty Drugs

    News Release

    Despite Medicare’s protections, Part D enrollees with serious health conditions can face thousands of dollars in annual out-of-pocket costs for expensive specialty drugs, a new KFF anaylsis finds. The analysis draws on data from Medicare’s Plan Finder website to calculate expected annual 2019 costs for more than two dozen specialty tier drugs used to treat four health conditions -- cancer, hepatitis C, multiple sclerosis and rheumatoid arthritis – based on coverage and costs in national and…

  • New KFF/Los Angeles Times Survey Highlights the Financial Challenges Facing People with Employer Health Benefits

    News Release

    A new KFF/Los Angeles Times survey of Americans with employer health benefits finds that although most are largely satisfied with their employer plan, many report financial challenges related to their health care costs, particularly among those facing high deductibles or suffering from chronic health conditions. The survey captures the experiences of the roughly 156 million Americans who get their health coverage through their employers, rather than through the individual market or government programs such as…

  • The Role of Medicaid for Adults With Chronic Illnesses

    Fact Sheet

    This report and related fact sheets provide data on spending, utilization, and access to care among low-income nonelderly adult Medicaid beneficiaries with chronic illnesses. Four fact sheets provide detail for beneficiaries with diabetes, respiratory disease, cardiovascular disease, and behavioral health conditions The reports show that, despite relatively high prevalence of chronic conditions and, correspondingly, relatively high spending and utilization rates, Medicaid beneficiaries with chronic illness report better access to care than their uninsured counterparts, many…

  • Health Affairs Article: Medicaid Expansion Under Health Reform May Increase Service Use and Improve Access For Low-Income Adults With Diabetes

    Issue Brief

    This analysis finds that Medicaid’s role in financing diabetes care will grow when many low-income uninsured people with diabetes become eligible for Medicaid as the program expansions under the Affordable Care Act in 2014. Adult Medicaid beneficiaries with diabetes had annual per person health expenditures more than three times higher than adult beneficiaries without the disease -- $14,229 versus $4,568, according to the study. At the same time, many uninsured adults with diabetes are less…

  • Quick Takes: Timely insights and analysis from KFF staff

    ACA Preventive Services at the Supreme Court

    Quick Insights

    If the Court rules in favor of Braidwood, private health insurers would no longer be required to cover, without cost sharing, certain preventive services recommended by USPTF after 2010 when the ACA was enacted.