Medicare Part D 2011 Data Spotlight: The Coverage Gap September 7, 2011 Report This data spotlight examines the availability of gap coverage in the private Medicare Part D drug plans offered to beneficiaries in 2011, the first year of the phase-out of the gap, as required under the 2010 health reform law. The changes for 2011 include a 50 percent discount on brand-name…
Managing Medicaid Pharmacy Benefits: Current Issues and Options September 1, 2011 Report This report examines reimbursement, benefit management and cost sharing issues in Medicaid pharmacy programs. The analysis, conducted by researchers from the Foundation’s Kaiser Commission on Medicaid and the Uninsured and Health Management Associates, focuses on the potential of several measures recently highlighted by Health and Human Services Secretary Kathleen Sebelius…
The Budget Trigger and Health Reform August 4, 2011 Perspective No doubt it will take some time to sort out how elements of the debt deal (formally “The Budget Control Act of 2011”) will all work. Delving into the details of how it affects subsidies in the Affordable Care Act (ACA) to make insurance more affordable helps to illustrate how…
July Kaiser Health Tracking Poll: Public Still Divided on ACA, Few Believe the Law Will Improve Consumer Protections July 28, 2011 Perspective Overall public opinion on the health reform law remains unchanged this month, with 42 percent of Americans holding a favorable view and 43 percent an unfavorable view. Even though previous Health Tracking polls have consistently shown that consumer protections were one of the least controversial and most widely supported provisions…
Medigap Reforms: Potential Effects of Benefit Restrictions on Medicare Spending and Beneficiary Costs July 20, 2011 Report As part of several debt-reduction and Medicare-reform proposals, some policymakers propose to prohibit Medicare supplemental insurance policies (known as Medigap) from covering all of enrollees’ out-of-pocket Medicare costs, which some believe leads to higher use of services and higher Medicare spending. Such changes would expose Medigap enrollees – currently about…
How Much Skin in the Game is Enough? The Financial Burden of Health Spending for People on Medicare May 30, 2011 Report How Much ” Skin in the Game ” is Enough? The Financial Burden of Health Spending for People on Medicare Medicare extends health security and financial protection to seniors and younger people with disabilities. However, premiums, relatively high cost-sharing requirements, and gaps in the benefit package result in some beneficiaries…
Accountable Care Organizations: A New Paradigm for Health Care Delivery? May 13, 2011 Event The health reform law of 2010 authorizes Medicare, beginning next year, to contract with accountable care organizations (ACOs) in a Medicare Shared Savings Program. ACOs provide financial incentives to improve the coordination and quality of care for Medicare beneficiaries, while reducing costs. But providers have raised red flags, saying the…
What the Actuarial Values in the Affordable Care Act Mean April 1, 2011 Issue Brief The Patient Protection and Affordable Care Act (PPACA) establishes four levels of coverage based on the concept of “actuarial value,” which represents the share of health care expenses the plan covers for a typical group of enrollees. As plans increase in actuarial value – bronze, silver, gold, and platinum –…
Federal Core Requirements And State Options In Medicaid: Current Policies And Key Issues April 1, 2011 Fact Sheet Medicaid is a jointly financed partnership between the federal government and states. The federal-state financing and administrative structure of Medicaid provides a framework of federal core requirements along with broad state options for program design and administration. This issue brief presents an overview of the current Medicaid program framework, with…
Health Reform Hits Main Street September 23, 2010 Video This short cartoon explains the problems with the current health care system, the health reform changes that are happening now, and the big changes coming in 2014 as part of the Affordable Care Act (ACA). You can view the video on our site and it is also available on YouTube.