Network Adequacy Standards and Enforcement
Health plan networks affect patient access to care. This brief reviews options for setting and enforcing network adequacy standards and tools for making differences in plan networks more transparent.
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Outpatient Visits Are Growing More Complex: Implications for Health Costs
Issue BriefThis 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.
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How Much Will Medicaid Physician Fees for Primary Care Rise in 2013? Evidence from a 2012 Survey of Medicaid Physician Fees
Issue BriefThis brief presents 50-state data from the 2012 KCMU/Urban Institute Medicaid Physician Fee Survey. It estimates that average Medicaid fees to qualified physicians for Affordable Care Act primary care services will rise by 73 percent when the primary care fee increase takes effect on January 1, 2013, although there will be wide state variation.
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National Survey of Physicians Part IV: Doctors, Payors, and Low-Income Patients
Poll FindingAs 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.
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New Report on the “Rising Cost of Living Longer” Details Medicare Spending by Age
News ReleaseA new report, The Rising Cost of Living Longer: Analysis of Medicare Spending by Age for Beneficiaries in Traditional Medicare, from the Kaiser Family Foundation takes a detailed look at per person Medicare spending by age and by service among the nearly 30 million people covered by traditional Medicare in 2011
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Paying a Visit to the Doctor: Current Financial Protections for Medicare Patients When Receiving Physician Services
News ReleaseAs the Congress continues to work on reforming Medicare payments for physician services, a new Kaiser Family Foundation brief examines key provisions in current law that help provide safeguards and financial protections for beneficiaries when they visit their doctor, and explains how potential changes could affect beneficiaries, providers, and the Medicare program.
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The ACA Primary Care Increase: State Plans for SFY 2015
PerspectiveThis perspective provides additional information on state plans related to the Affordable Care Act's (ACA) primary care rate increase after the 100% federal financing ends December 31, 2014. The data in this report were collected as part of KCMU’s Annual Medicaid Budget Survey, conducted by Health Management Associates with the support of the National Association of Medicaid Directors,
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What the Data Show: Black Women Report More Pervasive Negative Experiences in Health Care Compared to Other Groups
News ReleaseA new analysis of data from KFF’s Survey on Racism, Discrimination, and Health shows Black women are more likely than other groups to report being treated unfairly by a health care provider in recent years because of their race and ethnicity and that these experiences have health consequences.
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Trends in Medicaid Physician Fees, 2003-2008
Fact SheetThis study, published in a Health Affairs Web exclusive, provides the first national and state-by-state update of Medicaid physician fees since 2003. Medicaid has historically reimbursed physicians under fee-for-service at levels below what Medicare and private health insurers would pay for the same services.
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Medicare Advantage Enrollees Have Access to About Half of the Physicians Available to Traditional Medicare Beneficiaries
Issue BriefMedicare Advantage enrollees were in a plan that included just under half (48%) of all physicians available to traditional Medicare beneficiaries in their area in 2022, on average. The limitations of provider networks illustrate one of the key tradeoffs for beneficiaries in choosing Medicare Advantage for their coverage.