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  • The Small Share of Employers Offering Retiree Health Benefits Are Increasingly Turning to Medicare Advantage

    News Release

    Few employers offer retiree health benefits, and those that do increasingly are turning to Medicare Advantage plans to provide that coverage – a shift that has implications both for retirees and for federal spending, finds a new KFF analysis. Among the relatively small share of large firms (200 or more workers) that offer retiree health benefits to Medicare-age retirees, half (50%) provide these benefits through a Medicare Advantage plan in 2022, according to the analysis…

  • Medicare Advantage Plans Denied 2 Million Prior Authorization Requests in 2021, About 6% of Such Requests

    News Release

    Medicare Advantage plans denied two million prior authorization requests for health care services in whole or in part in 2021, or about six percent of the 35 million requests submitted on behalf of enrollees that year, a new KFF analysis finds. Prior authorization is intended to ensure that health care services are medically necessary by requiring providers to obtain approval before a service or other benefit is covered. While prior authorization has long been used…

  • A Review of 62 Studies Finds Few Big Differences Between Traditional Medicare and Medicare Advantage on a Variety of Measures

    News Release

    With the Medicare open enrollment period set to begin Oct. 15, a perennial decision faced by Medicare beneficiaries is whether to get their coverage through traditional Medicare or the private plans known as Medicare Advantage. A new KFF review of 62 studies published since 2016 that compares Medicare Advantage and traditional Medicare on measures of beneficiary experience, affordability, utilization, and quality finds few differences that are supported by strong evidence or have been replicated across…

  • What Happens When COVID-19 Emergency Declarations End? Implications for Coverage, Costs, and Access

    Issue Brief

    This brief provides an overview of the major health-related COVID-19 federal emergency declarations that have been made since early on in the pandemic, summarizes the flexibilities triggered by each, and identifies the implications for their ending, related to coverage, costs, and payment for COVID-19 testing, treatments, and vaccines; Medicaid coverage and federal match rates; telehealth; access to medical countermeasures through FDA emergency use authorization (EUA); and other Medicaid, Medicare and private health insurance flexibilities.

  • The Growth in Share of Medicare Advantage Spending

    Feature

    Earlier this week, the Biden Administration announced the final Medicare Advantage rates for 2023, which are projected to result in an average increase in Medicare Advantage plan revenue of 8.5% compared to 2022 - the highest average expected increase in recent years. Payments to Medicare Advantage plans as a share of total Medicare spending on Part A and Part B services have increased from 26% in 2010 to 45% in 2020, and are expected to…

  • Ending COVID-19 Emergency Declarations Will Bring an End to Flexibilities that Aided Patients, Providers, Insurers, and Public Programs in Responding to the Pandemic

    News Release

    When the federal government ends COVID-19 emergency declarations that were declared in the early days of the pandemic, it will bring to a close several changes that were enacted temporarily to enable the U.S. health care system to better deal with the crisis. A new KFF resource details a number of those flexibilities and lays out what it will mean for people, providers and federal health programs when they go away. One of the key…

  • Medicare Advantage Hospital Networks: How Much Do They Vary?

    Report

    This report takes an in-depth look at Medicare Advantage plans’ hospital networks. The analysis draws upon data from 409 Medicare Advantage plans serving beneficiaries in 20 diverse counties that together accounted for about one in seven (14%) Medicare Advantage enrollees nationwide in 2015. The report examines the size and composition of plans’ hospital networks, the variation across counties, the inclusion of Academic Medical Centers and NCI-Designated Cancer Centers, and the relationship between network size and…

  • KFF Analysis: Number of Coronavirus Cases, Distribution of $30B in CARES Act funding and Medicare Advantage Penetration by State

    Fact Sheet

    Number of Coronavirus Cases, Distribution of $30B in CARES Act funding and Medicare Advantage Penetration by StateStateNumber ofCOVID-19 Cases on April 21, 2020Percent of Total COVID-19 CasesFirst Distribution of CARES Act PaymentsPercent of Total Money DistributedPercent of Medicare Beneficiaries in Medicare Advantage, 2020New York253,400.0032.1%$1,859,574,4346.2%40%New Jersey88,806.0011.3%$919,426,8013.1%29%Massachusetts39,643.005.0%$841,425,1202.8%23%Pennsylvania34,005.004.3%$1,246,250,0764.2%41%California33,866.004.3%$2,920,960,7339.7%40%Michigan32,000.004.1%$936,700,1393.1%42%Illinois31,508.004.0%$1,204,103,1804.0%25%Florida27,058.003.4%$2,220,563,1377.4%43%Louisiana24,523.003.1%$474,891,7351.6%38%Connecticut19,815.002.5%$377,981,2571.3%41%Texas20,087.002.5%$2,089,066,4527.0%37%Georgia19,398.002.5%$792,069,1602.6%37%Maryland14,193.001.8%$742,225,3062.5%11%Ohio12,919.001.6%$989,773,4173.3%39%Washington12,486.001.6%$553,838,8061.8%33%Indiana11,688.001.5%$668,604,6142.2%32%Colorado10,112.001.3%$360,905,4821.2%38%Virginia9,097.001.2%$814,360,4672.7%21%Tennessee7,238.000.9%$739,723,3472.5%38%North Carolina6,979.000.9%$919,171,0873.1%36%Missouri5,963.000.8%$618,601,1672.1%35%Rhode Island5,090.000.6%$90,459,8340.3%39%Arizona5,068.000.6%$707,587,4822.4%39%Alabama5,092.000.6%$449,481,9451.5%41%Mississippi4,512.000.6%$374,847,7901.2%20%Wisconsin4,541.000.6%$471,681,0771.6%42%South Carolina4,439.000.6%$518,022,4631.7%28%Nevada3,830.000.5%$241,471,8410.8%36%Utah3,213.000.4%$185,292,4220.6%36%Iowa3,159.000.4%$297,929,1711.0%22%Kentucky3,050.000.4%$452,761,1711.5%34%District of Columbia3,098.000.4%$84,989,0990.3%20%Delaware2,745.000.3%$154,114,1180.5%17%Oklahoma2,680.000.3%$489,853,9981.6%22%Minnesota2,470.000.3%$472,206,1221.6%43%Kansas2,070.000.3%$325,135,9501.1%19%Oregon1,956.000.2%$291,029,0251.0%42%Arkansas1,990.000.3%$326,536,0431.1%26%New Mexico1,971.000.2%$169,486,1320.6%35%South Dakota1,685.000.2%$107,650,2010.4%19%Idaho1,736.000.2%$135,028,0560.5%33%Nebraska1,648.000.2%$225,027,9120.8%17%New Hampshire1,447.000.2%$164,580,3860.5%19%Puerto Rico1,298.000.2%$41,889,8220.1%70%West Virginia908.000.1%$246,574,8510.8%31%Maine875.000.1%$145,763,8120.5%36%Vermont816.000.1%$54,457,8700.2%12%North Dakota627.000.1%$91,064,5790.3%17%Hawaii584.000.1%$132,536,0760.4%44%Montana433.000.1%$111,503,2480.4%18%Alaska321.000.0%$71,248,1230.2%1%Wyoming429.000.1%$66,393,1630.2%3%NOTES: COVID-19 data as of 4/21/2020 at 10:38 AM.SOURCES: Johns Hopkins University, [Coronavirus COVID-19 Global Cases by the Center for…