Cost Sharing - Research and Data from KFF

Paying a Visit to the Doctor: Current Financial Protections for Medicare Patients When Receiving Physician Services

Apr 7, 2014

News Release

As the Congress continues to work on reforming Medicare payments for physician services, a new Kaiser Family Foundation brief examines key provisions in current law that help provide safeguards and financial protections for beneficiaries when they visit their doctor, and explains how potential changes could affect beneficiaries, providers, and the Medicare program. These provisions include: The participating provider program encourages physicians and other practitioners to charge no more than Medicare fees for services provided to…

How Much Is Enough? Out-of-Pocket Spending Among Medicare Beneficiaries: A Chartbook

Jul 21, 2014

Report

This new analysis and chartbook examines out-of-pocket spending among Medicare beneficiaries, including spending on health and long-term care services and insurance premiums, using the most current year of data available from a nationally representative survey of people on Medicare. It explores which types of services account for a relatively large share of out-of-pocket spending, which groups of beneficiaries (including by age, gender, health status, and chronic conditions) are especially hard hit by high out-of-pocket costs,…

Medicare Part D Prescription Drug Plans: The Marketplace in 2013 and Key Trends, 2006-2013

Dec 11, 2013

Issue Brief

This report presents findings from an analysis of the Medicare Part D marketplace in 2013 and changes in drug coverage and costs since 2006. It presents key findings related to Medicare drug plan availability, enrollment, premiums, low-income subsidies, the coverage gap, benefit design, cost sharing, formularies, and utilization management, based on data from CMS for all plans participating in Part D. The analysis was conducted jointly by researchers at Georgetown University, the Kaiser Family Foundation…

Out-of-Pocket Health Spending by Medicare Beneficiaries 65 and Older, by Gender and Type of Service, 2009

Sep 18, 2013

Feature

Out-of-Pocket Health Spending by Medicare Beneficiaries 65 and Older, by Gender and Type of Service, 2009 Download

Adult Preventive Services to be Covered by Private Plans Without Cost Sharing

Sep 18, 2013

Feature

Adult Preventive Services to be Covered by Private Plans Without Cost Sharing Download

2014 Employer Health Benefits Survey

Sep 10, 2014

Report

This annual Employer Health Benefits Survey (EHBS) provides a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing provisions, and other relevant information. The 2014 EHBS survey finds average family health premiums rose 3 percent in 2014, relatively modest growth by historical standards.

Implications of the Lapse in Federal COVID-19 Funding on Access to COVID-19 Testing, Treatment, and Vaccines

Mar 28, 2022

Issue Brief

A current impasse in Congress threatens continued funding for COVID-19 testing, treatment, and vaccines. The lack of additional federal COVID-19 funding has broad implications for access to these services, particularly for the uninsured, and could undermine efforts to ensure equitable access to these resources.

Ending COVID-19 Emergency Declarations Will Bring an End to Flexibilities that Aided Patients, Providers, Insurers, and Public Programs in Responding to the Pandemic

Apr 8, 2022

News Release

When the federal government ends COVID-19 emergency declarations that were declared in the early days of the pandemic, it will bring to a close several changes that were enacted temporarily to enable the U.S. health care system to better deal with the crisis. A new KFF resource details a number of those flexibilities and lays out what it will mean for people, providers and federal health programs when they go away. One of the key…

Millions of Medicare Part D Enrollees Have Had Out-of-Pocket Drug Spending Above the Catastrophic Threshold Over Time

Jul 23, 2021

Issue Brief

Medicare Part D, the outpatient prescription drug benefit for Medicare beneficiaries, provides catastrophic coverage for high out-of-pocket drug costs, but there is no limit on the total amount that beneficiaries have to pay out of pocket each year. Policymakers on both sides of the aisle support proposals to modify the design of the Part D benefit and establish a hard cap on out-of-pocket prescription drug spending by Part D enrollees. This analysis shows the number…

Millions of Medicare Part D Enrollees Have Had Out-of-Pocket Drug Costs High Enough to Exceed the Catastrophic Threshold Over Time

Jul 23, 2021

News Release

Nearly 3 million Medicare Part D enrollees had out-of-pocket drug spending above the catastrophic threshold in a recent five-year period, finds a new KFF analysis that takes a comprehensive look at how many people on Medicare have drug expenses high enough to push them above that limit. While the Part D drug benefit has helped make drugs more affordable for people with Medicare, the lack of a hard cap on annual out-of-pocket spending under Part…

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