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  • Transparency and Complexity

    Perspective

    This fall a new rule takes effect requiring all private health plans to offer a uniform, simple to read, summary of benefits and coverage (SBC).  The SBC will provide consumers with standardized information about how plans cover essential health benefits and what coverage limits and cost sharing applies. The SBC is one of the most popular provisions of the ACA.  Consumers often find health insurance difficult to understand and would no doubt welcome a plainly written…

  • Standard Medicare Prescription Drug Benefit, 2013

    Feature

    Standard Medicare Prescription Drug Benefit, 2013 Download Source Kaiser Family Foundation illustration based on CMS standard benefit parameter update for 2013.  Amounts rounded to nearest dollar.

  • Snapshots: Comparison of Expenditures in Nongroup and Employer-Sponsored Insurance: 2004-2007

    Issue Brief

    Data from the insurance industry and reviews of premiums offered through on-line sellers show that premiums for nongroup health insurance are lower than premiums reported on national surveys for employer-sponsored health insurance (ESI).  This paper uses pooled data from the 2004 through 2007 Medical Expenditure Panel Survey to compare the insurance payments for and out-of-pocket payments by people with nongroup health insurance and people with ESI.  While premiums for non-group coverage are lower than ESI…

  • Impact of Direct-to-Consumer Advertising on Prescription Drug Spending

    Report

    A new study by researchers at Harvard University and the Massachusetts Institute of Technology looks at the effect of direct-to-consumer (DTC) advertising on spending for prescription drugs. The study found that, on average, a 10% increase in DTC advertising of drugs within a therapeutic drug class resulted in a 1% increase in sales of the drugs in that class.

  • Medicare: The Essentials

    Feature

    Medicare: The Essentials (July 2013) Download Medicare Enrollment, 1966-2013 Download Source Centers for Medicare & Medicaid Services, Medicare Enrollment: Hospital Insurance and/or Supplemental Medical Insurance Programs for Total, Fee-for-Service and Managed Care Enrollees as of July 1, 2011: Selected Calendar Years 1966-2011; 2012-2013, HHS Budget in Brief, FY2014. Medicare Beneficiaries as a Percent of State Populations, 2012 Download Source Calculation based on Kaiser Family Foundation analysis of the CMS State/County Market Penetration file, March 2012;…

  • Transitions 2006

    Video

    On January 1, 2006, the six million Americans who are covered by both Medicare and Medicaid saw a change in how their prescription drugs are covered. The dual eligible population was transitioned from Medicaid into the Medicare prescription drug benefit. As a group, these beneficiaries are poorer and sicker than those on Medicare. Consequently, they have more extensive health and prescription drug needs than most Medicare beneficiaries.

  • Recent Publications on Medicaid and Prescription Drugs

    Other Post

    Recent Publications on Medicaid and Prescription Drugs The Kaiser Commission on Medicaid and the Uninsured continues to focus on the role of prescription drugs in the Medicaid program with particular attention on drug spending trends, state reforms to curb spending, and the impact on access to care. Listed below are the most recent publications on these important issues. Check back frequently for new publications. Case Study: Michigan's Medicaid Prescription Drug Benefit Medicaid and Prescription Drugs:…

  • Snapshots: The Prevalence and Cost of Deductibles in Employer Sponsored Insurance

    Issue Brief

    Over the past several years enrollees in employer-sponsored health plans have contributed more towards their care through the use of increased cost sharing.  The growth in deductibles is one of the more visible increases in employee cost sharing. A deductible is an amount that must be paid out-of-pocket by an enrollee before some or all services are covered by their health plan.  Health plans may impose deductibles on specific services, such as outpatient surgery or…

  • Snapshots: Employer Sponsored Health Insurance – A Comparison of the Availability and Cost of Coverage for Workers in Small Firms and Large Firms

    Issue Brief

    Employer Sponsored Health Insurance – A Comparison of the Availability and Cost of Coverage for Workers in Small Firms and Large FirmsNovember 2008 The majority of businesses in the United States are small businesses. Of the over three million firms with three or more workers, roughly 98% have between three and 199 employees. Small firms employ about 40% of all workers and about 34% of workers who receive health insurance through their own job.1 Small…