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  • Medicare Advantage Insurers Deny Prior Authorization Requests for Post Acute Care at Substantially Higher Rates Than the Overall Denial Rate

    Policy Watch

    Two recent reports find that Medicare Advantage organizations deny prior authorization requests for long-term care hospital, inpatient rehabilitation hospital, and skilled nursing facility stays at higher rates than requests overall. When these decisions are appealed, they are frequently overturned, particularly for skilled nursing facility stays. This may cause delays for Medicare beneficiaries who are particularly vulnerable or have high care needs.

  • AI: Show Me the Outcomes

    Podcast

    Chip talks with Dr. Toyin Ajayi, co-founder and CEO of Cityblock Health, which delivers value-based care to more than 100,000 Medicaid and dual-eligible members across ten states, many of them people of color managing chronic conditions. Ajayi makes a pointed case: Roughly 60 percent of health care AI investment goes to billing, coding, and risk adjustment — making sure someone gets paid — while only a fraction goes to delivering care. If we continue to…

  • How Do Health Expenditures Vary Across the Population?

    Issue Brief

    This analysis explores the variation in health spending across the population using 2023 Medical Expenditure Panel Survey data. Five percent of the population accounted for nearly half of all health spending in 2023.

  • Community Health Center Patients, Financing, and Services

    Issue Brief

    Community health centers served more than 32 million patients in medically underserved urban and rural areas in 2024. This brief reports on health center patients, services, and financing in 2024, using national data from the Uniform Data System (UDS).

  • Medicaid Coverage of and Spending on GLP-1s

    Issue Brief

    This brief discusses the current landscape of Medicaid GLP-1 coverage and examines recent trends in Medicaid prescriptions and gross spending on GLP-1s.

  • KFF/ESPN Survey of 1988 NFL Players

    Poll Finding

    The Survey of 1988 NFL players, conducted by KFF in partnership with ESPN, looks at the overall health and well-being of former professional football players who played in the 1988 NFL season. While many are grappling with the immense toll the sport has taken on their physical and neurological health, most say they would do it all over again.