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KFF and the Peterson Center on Healthcare examine market trends contributing to rising health costs and identify several potential federal and state policy issues to watch throughout 2025, including high-cost drugs, federal funding cuts, and workforce shortages.
This brief compares the prices paid by private insurers for hospital care to increases in Medicare payment using data from the Bureau of Labor Statistics (BLS) Producer Price Index (PPI), finding that hospital prices have risen much faster for private insurance than Medicare since 2019.
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…
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…
High U.S. prices and demand for Ozempic and Wegovy have implications for insurance premiums, public program costs, and affordability.
It’s quite likely that one of these popular anti-obesity medications will be selected for negotiation in the next round of Medicare’s relatively new drug price negotiation program.
Ultimately, assessing the impact of President Trump’s newest iteration of “Most Favored Nation” drug pricing depends on details that have yet to be fleshed out.
Voluntary efforts by drug companies to lower prices on selected medications, such as this new discounted price for Eliquis and previous price reductions on certain insulin products, could expand access to lower-priced drugs for some patients, but are not likely to improve prescription drug affordability in the U.S. on a widespread basis.
Extending the short-term GLP-1 Bridge program is good news for eligible Medicare beneficiaries because it provides the certainty of obesity drug coverage at a $50 copay for a longer duration, but federal spending will also rise by some unknown amount since CMS hasn’t disclosed the projected cost.
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