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This conference report summarizes discussions at a March 2018 conference in Washington with 30 leaders from the health care community to launch Initiative 18/11, a partnership between the Society of Actuaries and KFF to address the rising cost of health care in the United States. It also lays out the next steps for the initiative.
Medicare Part D has helped to make prescription drugs more affordable for people with Medicare, yet many beneficiaries continue to face high out-of-pocket costs for their medications. Specialty tier drugs are a particular concern for Part D enrollees in this context. This analysis draws on data from Medicare’s Plan Finder website to calculate expected annual 2019 out-of-pocket costs for 30 specialty tier drugs used to treat four health conditions—cancer, hepatitis C, multiple sclerosis, and rheumatoid…
Despite Medicare’s protections, Part D enrollees with serious health conditions can face thousands of dollars in annual out-of-pocket costs for expensive specialty drugs, a new KFF anaylsis finds. The analysis draws on data from Medicare’s Plan Finder website to calculate expected annual 2019 costs for more than two dozen specialty tier drugs used to treat four health conditions -- cancer, hepatitis C, multiple sclerosis and rheumatoid arthritis – based on coverage and costs in national and…
Antiviral medications, including those that treat hepatitis C and HIV/AIDS, cost the Medicaid program more money (before rebates) than any other group of outpatient prescription drugs for each year from 2014 to 2017, according to a new KFF analysis. The analysis of utilization and spending trends finds that antivirals accounted for more than 13 percent of the $63.6 billion in Medicaid outpatient drug spending pre-rebates in 2017 -- a level disproportionate to their utilization and…
This slideshow explores prescription drug spending for people who are covered by large employer health plans.
Medicare Part D is a voluntary outpatient prescription drug benefit for people with Medicare provided through private plans, including stand-alone prescription drug plans and Medicare Advantage plans that offer drug coverage. This analysis provides an overview of Medicare Part D premiums and cost sharing in 2027 and key trends over time.
Data from the Centers for Medicare & Medicaid Services (CMS) shows that 4.3 million Medicare beneficiaries, including 3.1 million Medicare Advantage drug plan enrollees and 1.2 million PDP enrollees, will have their plan terminated at the end of 2026. An additional 1.4 million Medicare Advantage enrollees are in a plan that is consolidating with another plan offered by the same insurer.
A new KFF analysis finds that the average monthly premium for Medicare Part D coverage in stand-alone prescription drug plans (PDPs) will increase to $51 in 2027, up 50% from $34 in 2026, if current enrollees don’t switch into lower-premium plans during open enrollment, which runs through December 7.
This analysis finds that CMS’s proposed cut to Medicare reimbursement for 340B drugs, and accompanying increase for other outpatient services, will reduce revenues among safety-net hospitals while increasing revenues among for-profit hospitals.
This is the 28th Employer Health Benefits Survey (EHBS) and reflects employer-sponsored health benefits in 2026. As in years past, the survey examines trends in employer coverage, including premiums, employee contributions, deductibles, offer rates, and employer practices. This year, we asked employers detailed questions about satisfaction with their health plans; coverage of GLP-1 agonists and IVF; actions taken in response to projected cost increases; and firms’ ability to obtain information about health care costs and…
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