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  • Analysis: Inconsistencies Within Hospital Price Transparency Data Make Cost Comparisons Difficult

    News Release

    Since 2021, federal law has required hospitals to publicly post information about their standard prices and negotiated discount rates for common health services to encourage consumers to compare prices and to promote competition. To date, however, the transparency data currently shared by hospitals to comply with the law are messy, inconsistent and confusing, making it challenging, if not impossible, for patients or researchers to use them to compare prices across hospitals or payers, a new…

  • Ongoing Challenges with Hospital Price Transparency

    Issue Brief

    This analysis examines transparency data currently shared by hospitals to comply with federal law and finds that they are messy, inconsistent and confusing, making it challenging if not impossible for patients or researchers to use them to compare prices. Many of these shortcomings stem from a lack of specificity in the requirements for what hospitals must report.

  • Hospital Charity Care: How It Works and Why It Matters

    Issue Brief

    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.

  • Half of All Hospitals Have Charity Care Costs That Represent 1.4% or Less of Their Operating Expenses

    News Release

    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 hospitals provide little or no charity care (0.1% or less of operating expenses at 8% of hospitals), while others provide far more charity care (at…

  • 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.

  • Prices Increased Faster Than Inflation for Half of all Drugs Covered by Medicare in 2020

    Issue Brief

    Recent legislation would require drug companies to pay rebates to the federal government when annual increases in prescription drug prices for Medicare and private insurance exceed the rate of inflation. As context for understanding the possible impact of this proposal, this analysis compares price changes for drugs covered by Medicare Part B (administered by physicians) and Part D (retail prescription drugs) between 2019 and 2020 to the inflation rate over the same period.

  • Millions of Medicare Beneficiaries Use Prescription Drugs That Could Be Subject to Price Negotiation, But Build Back Better Act Provision Exempts Many Drugs With High Federal Spending

    News Release

    Twenty drugs and dozens of insulin products used by 8.5 million Medicare beneficiaries would be subject to government drug price negotiation if the Build Back Better Act (BBBA) were enacted and fully implemented in 2022, according to a new KFF analysis. The 20 drugs include 18 drugs available to beneficiaries covered under Medicare Part D (typically drugs purchased at the pharmacy) and two drugs covered under Medicare Part B (physician-administered drugs). The list includes drugs…

  • Simulating the Impact of the Drug Price Negotiation Proposal in the Build Back Better Act

    Issue Brief

    The Build Back Better Act (BBBA) includes a range of health and other proposals supported by President Biden, including a proposal to allow the federal government to negotiate the price of some prescription drugs covered under Medicare Part B (administered by physicians) and Medicare Part D (retail outpatient drugs). This brief illustrates the potential scope of the drug price negotiation proposal in the BBBA. This analysis is designed to highlight the types of Medicare-covered drugs…