Are the Tradeoffs from Prior Authorization Worth It?
In his latest column, President and CEO Dr. Drew Altman asks if prior authorization review could be eliminated entirely, discussing how it might be done and the tradeoffs.
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In his latest column, President and CEO Dr. Drew Altman asks if prior authorization review could be eliminated entirely, discussing how it might be done and the tradeoffs.
As Republican policymakers consider how to repeal and replace the Affordable Care Act (ACA), they are likely to face a number of decisions about whether to retain any of the law’s changes to Medicare. Repealing the ACA has potential implications for Medicare spending, beneficiaries, and other stakeholders, according to a new Kaiser Family Foundation brief. A full repeal of the ACA would undo all of the law’s changes to Medicare and would increase Medicare spending,…
Medicare Advantage plans, which consist primarily of HMOs and PPOs, now cover almost 18 million people – nearly one-third of all Medicare beneficiaries. Medicare Advantage plans have been in the news lately because the proposed merger between Aetna and Humana, which together account for one-quarter of all Medicare Advantage enrollees, could further consolidate the Medicare Advantage market. A Kaiser Family Foundation analysis, featuring the latest publicly available data on the 2017 Medicare marketplace, examines new…
The analysis examines enrollment in Medicare Advantage plans during beneficiaries’ first year on Medicare and finds that less than one-third or 29% enrolled in these private health plans, including HMOs or PPOs. The majority of people new to Medicare are choosing traditional Medicare in the year they first go on Medicare. The study looks at how these findings vary across age, Medicaid status, states, and counties.
Medicare Advantage plans gain beneficiaries from traditional Medicare who have lower average spending and use fewer health services than similar beneficiaries who choose to remain in traditional Medicare, according to a new KFF analysis. The analysis finds that people who switched from traditional Medicare to Medicare Advantage in 2016 had health spending in 2015 that was $1,253 less, on average, than the average spending for beneficiaries who remained in traditional Medicare (after adjusting for health…
Medicare does not cover routine dental care, and two-thirds of the Medicare population have no dental coverage at all. With limited or no dental coverage, some incur high out-of-pocket costs, while others forgo need dental care because they can’t afford it. Policymakers in Washington and others are exploring ways to make dental care more affordable for the 60 million people on Medicare. A new KFF brief examines five potential ways to make oral health care…
Three key private health insurance markets -- Medicare Advantage, the individual market and the fully-insured group market -- appear to be financially healthy and attractive to insurers. The private Medicare Advantage market generates significantly larger gross margins per person than the individual market or fully-insured market. The future of these markets has become a focus for policymakers amid the debate over Medicare for All.
Three key private health insurance markets -- Medicare Advantage, the individual market and the fully-insured group market -- appear to be financially healthy and attractive to insurers, according to a new KFF analysis. The private Medicare Advantage market generates significantly larger gross margins per person than the individual market or fully-insured market, the analysis finds. The future of these markets has become a focus for policymakers amid the debate over Medicare for All. Some proposals…
This tutorial was produced for kaiserEDU.org, a Kaiser Family Foundation website that ceased production in September 2013. The kaiserEDU.org tutorials are no longer being updated but have been made available on kff.org due to demand by professors who are using the tutorials in class assignments. You may search for other tutorials to view on kff.org. To download this or other tutorials, visit the tutorials archive page. Slides are available for download using the “Download Slides” link within the…
This Data Spotlight provides an overview of Medicare Advantage enrollment patterns in March 2013, and examines variations by plan type, state, and firm. It also analyzes trends in premiums paid by beneficiaries enrolled in Medicare Advantage plans, including variations by plan type, and describes the out-of-pocket limits and prescription drug coverage in the Part D “donut hole” provided by the plans in 2013.
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