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  • KFF Analysis Finds Physician Networks in ACA Marketplace Plans Vary Widely, and Enrollees Typically Pay More in Premiums to Access Broader Networks

    News Release

    A KFF analysis of physician networks in the Affordable Care Act’s Marketplace plans finds wide variations in the share of local practicing physicians who participate, with the least costly plans generally having a smaller share of physicians than more expensive plans. The analysis examines the breadth of physician networks listed in Marketplace plan directories in 2021 in nearly every county nationally in relation to the number of actively practicing physicians locally.  On average, Marketplace enrollees…

  • Outpatient Visits Are Growing More Complex: Implications for Health Costs

    Issue Brief

    This analysis for the Peterson-KFF Health System Tracker uses claims data from private, large employer-based plan to examine trends in complexity coding across outpatient practice settings from 2004 to 2021. It finds a trend toward higher complexity codes that contributes to higher outpatient spending.

  • The AI Arms Race in Administrative Health Care

    Podcast

    Caroline Pearson, executive director of the Peterson Health Technology Institute (PHTI) and the Peterson Center on Healthcare, joins Chip to discuss who really benefits as AI moves into health care's back office. A quiet arms race is underway — providers deploying AI to code, bill, and capture revenue and insurers deploying it right back to review, deny, and hold the line. The open question is whether any of this lowers what the country actually spends…

  • Guardrails for AI in Health Care — How High?

    Podcast

    AI is racing into everyday medicine. The rules of the road are still being written. Dr. Michelle Mello of Stanford, professor at both the Law School and the School of Medicine, and co-leader of its Healthcare Ethical Assessment Lab for AI, joins Chip to address the questions that trail every advance this series has covered: who makes the rules, who ensures the technology gets it right — and who answers when it doesn't?

  • Ten Things to Know About Consolidation in Health Care Provider Markets

    News Release

    Mergers and acquisitions involving hospitals and other health care providers are drawing attention from federal and state regulators, including the Federal Trade Commission, and policymakers amid concerns that such consolidations can reduce competition and contribute to the high costs of health care. A new KFF brief examines and summarizes the evidence about consolidation among health care providers as more community hospitals become part of a larger system, and more physicians are in practices owned by…

  • National Survey of Physicians Part IV: Doctors, Payors, and Low-Income Patients

    Poll Finding

    As part of the Kaiser Family Foundation's National Survey of Physicians, this portion of the survey examines differences in provider payment rates from different payors, such as Medicaid, Medicare, and private insurers, and explores providers experiences with these different payors and with providing treatment for uninsured and low-income patients. Highlights and Chart Pack

  • Five Facts About Black Women’s Experiences in Health Care

    Issue Brief

    This brief examines Black women's experiences in health care, including unfair treatment by providers due to race and their health outcomes as a result of this treatment. The brief also explores the association between racially concordant providers and positive health care experiences among Black women.