Cost Sharing - Research and Data from KFF

An Analysis of the Share of Medicare Beneficiaries Who Would Benefit from an Annual Out-of-Pocket Maximum under Traditional Medicare Over Multiple Years

Jun 18, 2013

Issue Brief

This analysis examines the share of Medicare beneficiaries who would be helped over time if the program were to add a limit on out-of-pocket spending to traditional Medicare. This analysis was conducted jointly with the Medicare Payment Advisory Commission (MedPAC) in response to a request made during a Feb. 26, 2013 hearing of the House Ways and Means' Subcommittee on Health.

JAMA Forum: What Is Health Care Cost Containment?

Sep 6, 2012

Perspective

"What Is Health Care Cost Containment?" Larry Levitt's September 2012 contribution to The JAMA Forum, is now available online.

An Examination of Surprise Medical Bills and Proposals to Protect Consumers from Them

Jun 20, 2019

Issue Brief

This analysis examines how often patients get hit with surprise medical bills, what circumstances tend to give rise to them and what proposals are being considered to protect consumers from this problem.

How Many Medicare Part D Enrollees Had High Out-of-Pocket Drug Costs in 2017?

Jun 21, 2019

Issue Brief

The Medicare Part D prescription drug benefit has helped improve the affordability of medications for people with Medicare. Yet Part D enrollees can face relatively high out-of-pocket costs because the Part D benefit does not have a hard cap on out-of-pocket spending. This analysis presents the latest data on out-of-pocket drug spending among Medicare Part D enrollees without low-income subsidies who have costs above the catastrophic coverage threshold.

How Will The Medicare Part D Benefit Change Under Current Law and Leading Proposals?

Oct 11, 2019

Issue Brief

This brief describes how the Medicare Part D benefit will change in 2020 under current law and proposed changes that would affect what beneficiaries, plans, manufacturers, and Medicare pay for drug costs under Part D in the future.

Medicare Part D Beneficiaries Who Reach the Catastrophic Coverage Limit Can Expect to Pay More Out-of-Pocket for Their Prescription Drugs Next Year

Oct 11, 2019

News Release

Medicare Part D enrollees with relatively high out-of-pocket expenses can expect see their costs rise in 2020, according to a new KFF analysis. This is mainly due to an increase in how much enrollees will pay out of pocket for their prescription drugs in the Part D benefit coverage gap phase before they qualify for catastrophic coverage. The analysis finds that out-of-pocket drug costs will increase by nearly $400 -- from $2,275 in 2019 to…

Medicare Advantage 2020 Spotlight: First Look

Oct 24, 2019

Issue Brief

In 2020, more than 22 million Medicare beneficiaries (34%) are enrolled in Medicare Advantage plans, which are mainly HMOs and PPOs offered by private insurers as an alternative to the traditional Medicare program. This data note provides an overview of the Medicare Advantage plans that will be available in 2020, including the variation in the number of plans available by county and plan type. The brief also examines the insurers entering the Medicare Advantage market…

Modifying Traditional Medicare’s Benefit Design Could Reduce Federal Spending But With Cost Tradeoffs Between Beneficiaries and The Federal Government

Jun 29, 2016

News Release

Revamping traditional Medicare’s benefit design and restricting “first-dollar” supplemental coverage could reduce federal spending, simplify cost sharing, protect against high medical costs, decrease out-of-pocket spending for many beneficiaries, and provide more help to those with low incomes -- but would be unlikely to achieve all of these goals simultaneously.

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

Jan 29, 2019

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…

Key Issues in Understanding the Economic and Health Security of Current and Future Generations of Seniors

Mar 3, 2012

Issue Brief

As part of broad deficit-reduction plans, policymakers are considering reforms to the nation's three major entitlement programs - Medicare, Medicaid and Social Security - that could significantly affect the economic security of seniors in their retirement years. This brief examines the role of these programs in ensuring seniors' financial security as well as the challenges facing current and future generations when it comes to economic and health security. Drawing from current research and data, the…

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