Prices

Attention to high list prices continues at both the state and federal levels with a number of policy proposals aimed at lowering drug prices and there is renewed interest in drug prices and reimbursement within Medicaid. Changes made in 2016 to federal rules governing how state Medicaid programs pay for drugs aimed to make the prices paid more accurate, but increased reliance on pharmacy benefit managers (PBMs) pose challenges to drug price transparency. This brief explains Medicaid prescription drug prices to help policymakers and others understand Medicaid’s role in drug pricing and any potential consequences of policy changes for the program.

We review several policy options to constrain health care spending, primarily by putting downward pressure on provider prices, including price regulation, global budgets, and spending growth targets.

This analysis illustrates the potential total cost of Pfizer and Moderna COVID-19 vaccines, based on their publicly-announced expected prices, once they enter the U.S. commercial market. It compares the average price paid by the federal government for the COVID-19 bivalent boosters to the estimated average commercial prices across different scenarios.

Half of hospitals reported that the cost of providing charity care to patients represented 1.4% or less of their operating expenses in 2020, though the rates vary widely from hospital to hospital, a new KFF analysis finds. Based on a review of hospital cost report data, the analysis finds some…

This issue brief examines the role that hospital charity care programs play in helping patients who are unable to afford their care. It describes how hospital charity care programs work, the amount of charity care that hospitals provide, relevant federal and state regulation, the role of Medicare and Medicaid in helping hospitals afford charity care expenses, and policy proposals related to charity care programs.

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.

This analysis finds that privately insured adults who were treated for depression and/or anxiety in 2021 spent almost twice as much on annual out-of-pocket costs compared to enrollees who were not treated for a mental health diagnosis.

After the public health emergency ends on May 11, private health plans will no longer be required to cover the full cost of COVID-19 tests ordered or administered by a clinician or to reimburse consumers for at-home rapid tests. To estimate what consumers might have to pay for tests, KFF’s…

This analysis examines the potential costs for COVID-19 testing that some consumers may face once the COVID-19 public health emergency ends on May 11, 2023., depending on whether they have insurance and how their insurance covers testing.