Testimony: Prior Authorization in Medicare Advantage May 17, 2023 Issue Brief Jeannie Fuglesten Biniek, an Associate Director for the Program on Medicare Policy at KFF, testified before the Senate Homeland Security and Government Affairs Committee Permanent Subcommittee on Investigations on May 17, 2023 as part of a hearing on Examining Health Care Denials and Delays in Medicare Advantage.
Half of All Eligible Medicare Beneficiaries Are Now Enrolled in Private Medicare Advantage Plans May 1, 2023 Blog Recently released data show that Medicare Advantage, the private plan alternative to traditional Medicare, now covers half of eligible Medicare beneficiaries. As the role of Medicare Advantage grows, so will interest in understanding how well the program serves the increasingly diverse group of enrollees who receive their Medicare coverage from private insurers.
Mental Health and Substance Use Disorder Coverage in Medicare Advantage Plans April 28, 2023 Issue Brief This brief describes the scope of mental health and substance use disorder benefits in Medicare Advantage plans, including extra benefits, cost sharing, and prior authorization and referral requirements, based on an analysis of the Centers for Medicare and Medicaid Services (CMS) Medicare Advantage plan benefit and enrollment files for 2022.
Gaps in Medicare Advantage Data Limit Transparency in Plan Performance for Policymakers and Beneficiaries April 25, 2023 Issue Brief In this brief we identify specific gaps in Medicare Advantage data and discuss the implications for program oversight and beneficiary decision making.
Access Problems And Cost Concerns Of Younger Medicare Beneficiaries Exceeded Those Of Older Beneficiaries In 2019 April 3, 2023 Issue Brief Published in the journal Health Affairs, this analysis compared measures of access to care, cost concerns, and satisfaction with care for beneficiaries younger than age sixty-five versus those ages sixty-five and older, using the 2019 Medicare Current Beneficiary Survey.
Increasingly Privatized Public Health Insurance Programs in the US March 30, 2023 Perspective In this JAMA Forum column, KFF’s Larry Levitt examines the growing role of private insurance companies in public programs, including Medicare Advantage and Medicaid managed care, and the tradeoffs that result.
March 21 Web Event: Unpacking the Controversy Over Medicare Advantage March 21, 2023 Event Medicare Advantage is the rapidly growing private plan alternative to traditional Medicare that provides coverage to approximately half of Medicare beneficiaries. Controversy has arisen over a Biden Administration proposal for changes to payments to insurers for the coming year, including how the health risk of enrollees is captured, as well…
Medicare Advantage Insurers Report Much Higher Gross Margins Per Enrollee Than Insurers in Other Markets February 28, 2023 News Release A new analysis of health insurers’ 2021 financial data shows that insurers continue to report much higher gross margins per enrollee in the Medicare Advantage market than in other health insurance markets. The analysis examines insurers’ financial data in the Medicare Advantage, Medicaid managed care, individual (non-group), and fully insured…
Health Insurer Financial Performance in 2021 February 28, 2023 Issue Brief Using health insurer financial data for 2021, we find that Medicare Advantage insurers reported gross margins that were at least twice as high as those reported by insurers in the individual/non-group, fully-insured group/employer, and Medicaid managed care markets. The four markets report similar simple medical-loss-ratios.
Is the Biden Administration Proposing Cuts to Medicare Advantage? February 17, 2023 Blog Recent announcements by the Administration to improve the accuracy of payments and improve program integrity of Medicare Advantage are unlikely to have a major impact on the program, the insurance industry or beneficiaries, given relatively generous payments to plans and the robustness of the market for private Medicare plans.