Prices

As the Biden administration begins the process of negotiation drug prices for Medicare as authorized in the Inflation Reduction Act, KFF’s Larry Levitt probes some of the arguments against it and the policy and political implications of the debate in this New York Times op-ed column.

This brief explains the role and implications of cross-market mergers between hospitals and health systems that operate in different regions and describes the approaches that government antitrust agencies have taken in reviewing these types of transactions.

This brief explains the role of federal and state antitrust agencies in challenging anticompetitive practices among hospitals and other health care providers, including the legal authority of federal and state agencies, the role that they play in enforcing antitrust laws, and proposed options for strengthening their authority.

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.

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.

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,…

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.

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.