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  • Examining the Potential Impact of Medicare’s New WISeR Model

    Issue Brief

    On January 1, 2026, the Center for Medicare & Medicaid Innovation (CMMI) launched the Wasteful and Inappropriate Service Reduction (WISeR) Model that establishes new prior authorization requirements in traditional Medicare. This analysis explores the potential impact of the WISeR model by examining recent spending and utilization trends in traditional Medicare for services selected for prior authorization requirements in the six model states (Arizona, New Jersey, Ohio, Oklahoma, Texas, and Washington).

  • COVID-19 Test Prices and Payment Policy

    Issue Brief

    This analysis examines list prices for COVID-19 testing at the largest hospitals in every state and finds they range widely from $20 to $850. Federal law now requires private insurers to cover COVID-19 tests at no cost to the patient and provides funding for people without health insurance.

  • High Health-Care Prices: More Talk Than Action

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman explores how price is the major factor that distinguishes the cost of our health care system from those in other developed nations, yet most efforts in the U.S. to address health-care costs don’t focus on price much at all.

  • Health of the Healthcare System: An Overview

    Feature

    This slideshow accompanies the video, “Health of the Healthcare System,” a diagnostic look at the state of the U.S. healthcare system. It compares the United States to other countries in four key areas: health, quality of health care, cost of care, and accessibility.

  • Price Transparency and Price Variation in U.S. Health Services

    Issue Brief

    A new Peterson-KFF analysis examines the potential impact of new federal price transparency rules on patient decision-making and market pricing for health services. The brief also includes new analysis of geographic variation in health prices.

  • Half of Admissions in the Large Group Market Are Paid Above 150% of Medicare Rates, Excluding Maternity Admissions

    Issue Brief

    This analysis looks at in-network payment rates for inpatient hospital stays, other than maternity/newborn admissions, among large employer plans relative to Medicare payment rates. We find that a cap of 150% of Medicare rates would affect 52% of in-network admissions and 36% of in-network spending, while a cap of 300% of Medicare rates would affect 13% of in-network admissions and 13% of in-network spending, with variation across types of admissions.