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  • Medicaid Payment for Outpatient Prescription Drugs

    Fact Sheet

    This fact sheet summarizes Medicaid’s role as the major source of outpatient pharmacy services for low-income Americans. Medicaid spent $25.4 billion on prescription drugs in fiscal year 2009, and outpatient prescription drug coverage is an optional benefit that all state Medicaid programs currently provide. Fact Sheet (.pdf)

  • Choosing a Medicare Part D Plan: Are Medicare Beneficiaries Choosing Low-Cost Plans?

    Report

    Since 2006, Medicare beneficiaries have had the opportunity to choose from among dozens of plans to get the Part D prescription drug benefit, facing wide variation in benefits, premiums and cost-sharing. The array of choices, with more than 50 stand-alone drug plans in many states, could allow beneficiaries to select a plan that provides the best value for their individual medical and economic needs. This study uses actual pharmacy claims experiences, and premium and cost-sharing…

  • Medicare Part D 2010 Data Spotlight: Benefit Design and Cost Sharing

    Report

    The Medicare Modernization Act established a defined standard drug benefit for Part D stand-alone Prescription Drug Plans (PDPs) and Medicare Advantage Prescription Drug (MA-PD) plans, while giving plans flexibility to offer alternative benefit designs. Only about one in 10 PDPs offer the standard benefit in 2010. Plan sponsors can offer alternative benefit designs that are, at a minimum, actuarially equivalent to the defined standard and can also offer enhanced benefits. This Medicare Part D data…

  • The Role of Clinical and Cost Information in Medicaid Pharmacy Benefit Decisions: Experience in Seven States

    Issue Brief

    This policy brief provides perspective on the potential for using comparative effectiveness research in Medicaid pharmacy programs by looking at seven states to determine how they currently evaluate relative clinical and cost information about prescription drugs when making coverage decisions for their Medicaid pharmacy benefits. The brief was prepared by researchers at the Foundation's Kaiser Commission on Medicaid and the Uninsured and Avalere Health. Policy Brief (.pdf)

  • Toplines: June 2006 Kaiser Health Poll Report

    Poll Finding

    These toplines include selected findings from the June 2006 Kaiser Health Poll Report Survey, a bimonthly survey designed to provide key tracking information on public opinion about health care topics. Toplines (.pdf)

  • Summary of Key Changes to Medicare in 2010 Health Reform Law   

    Issue Brief

    Summary of Key Changes to Medicare in 2010 Health Reform Law . This brief provides a detailed look at the improvements in Medicare benefits, changes to payments for providers and Medicare Advantage plans, various demonstration projects and other Medicare provisions in the law. It includes a timeline of key dates for implementing the Medicare-related provisions in the law.

  • Explaining Health Care Reform: What is Comparative Effectiveness Research?

    Issue Brief

    The brief examines current funding for comparative effectiveness research, the provisions included in the current health reform legislation, and issues related to which treatments that might be studied, whether and how to weigh costs of care, and how such findings will be used and shared with health-care practitioners and the public. It is part of the Foundation's series of Explaining Health Reform briefs on key concepts in health reform. Brief (.pdf)

  • Medicare and the President’s Fiscal Year 2009 Budget Proposal

    Fact Sheet

    Medicare and the President's Fiscal Year 2009 Budget Proposal This fact sheet summarizes key Medicare-related provisions in the Bush Administration's fiscal year 2009 budget proposal, as well as additional legislation that responds to the Medicare Trustees' "Medicare Funding Warning." Fact Sheet (.pdf)

  • State Financing of the Medicare Drug Benefit:  New Data on the “Clawback”

    Issue Brief

    State Financing of the Medicare Drug Benefit: New Data on the "Clawback" Beginning in 2006, states will be obligated to finance part of the new Medicare prescription drug benefit via a monthly "clawback" payment to the federal government. This issue update analyzes the latest data and provides an overview of the state financing of the Medicare drug benefit. Issue Brief (.pdf)