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  • Analysis Examines the Implications of Price Transparency for Providers and Patients as New Rules Go into Effect

    News Release

    A new KFF analysis examines how new federal rules on price transparency for health services may affect patient decision-making and market pricing. As of January 1, 2021, the United States Department of Health and Human Services requires that hospitals publish payer-negotiated rates for common services on their websites. A second set of rules, which requires insurers to provide rate and cost-sharing estimates for common services, is scheduled to go into effect in 2023. While the…

  • Prescription Drugs’ Sizable Share of Health Spending

    News Release

    In his latest column for The Wall Street Journal‘s Think Tank, Drew Altman explains why prescription drug spending may be a larger share of health spending than most people think, depending on how you look at it. All previous columns by Drew Altman are online.  

  • How Many People with Employer-Sponsored Insurance Use the Drugs Slated for Medicare Price Negotiations

    Issue Brief

    Among the 167 million people with employer-sponsored insurance in 2022, 3.4 million used at least one of the first 10 drugs identified for Medicare price negotiations, according to a new analysis. The most used drug for people with employer-sponsored health insurance was Jardiance, a drug used to treat diabetes and heart failure, which was taken by more than 911,000 enrollees. The analysis uses the Merative MarketScan 2022 commercial claims to estimate the number of enrollees…

  • Nearly Half of Metro Areas Have Only One or Two Hospitals or Health Systems Providing Inpatient Care

    News Release

    Nearly half (47%) of metropolitan areas across the country had only one or two hospitals or health systems providing general inpatient hospital care in 2022, a new KFF analysis finds.The analysis examines the extent of competition among hospitals amid a wave of hospital consolidation that has drawn the attention of state and federal regulators. About one in five (19%) metropolitan statistical areas have only one hospital or health system providing hospital care, and more than…

  • The Performance of the Federal Independent Dispute Resolution Process through Mid-2024

    Issue Brief

    The No Surprises Act, which was signed into law by President Trump during his first term and took effect in 2022, aims to protect consumers from certain surprise medical bills. The law established processes to keep the patient out of the payment negotiations between the provider and the plan. In the event of an unsuccessful negotiation, providers and payers enter an independent dispute resolution (IDR) process in which a designated third-party arbitrator examines eligible evidence…

  • Unpacking the Prescription Drug Provisions of the Build Back Better Act

    Event Date:
    Event

    As the Build Back Better Act shifts from the House to the Senate, there’s considerable interest in provisions that would lower the cost of prescription drugs. The House-passed bill would allow the federal government to negotiate prices for some high-cost drugs in Medicare, and set a hard cap on out-of-pocket drug spending for Medicare Part D enrollees.  For people with Medicare and private insurance, the legislation would limit annual increases in drug prices and cap…

  • Why Affordability Is the Big Tent

    From Drew Altman

    In this column, KFF President and CEO Drew Altman explores why the public's concerns about out-of-pocket health costs make health care affordability the health policy issue most likely to resonate with voters across the political spectrum.