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With the Medicare open enrollment period set to begin Oct. 15, a perennial decision faced by Medicare beneficiaries is whether to get their coverage through traditional Medicare or the private plans known as Medicare Advantage.
This literature review examines 62 studies published since 2016 that compare Medicare Advantage and traditional Medicare based on measures of beneficiary experience, affordability, service utilization, and quality.
In September 2023, the Centers for Medicare and Medicaid Services (CMS) announced a new opportunity for states to leverage federal funding on health care: the Advancing All-Payer Health Equity Approaches and Development (AHEAD) model. With this model, CMS – under the auspices of the CMS Innovation Center, also known as CMMI -- aims to reduce the rate of growth in health care spending, improve people's health, and reduce disparities in health outcomes. This issue brief answers some key questions about the new model and explores considerations for potential state and private participants.
This brief summarizes findings from 20 studies published between January 1, 2018 and April 1, 2023 that compare quality of care and beneficiary experiences between people of color in Medicare Advantage and White enrollees, or the total Medicare Advantage population.
KFF and the American Society of Clinical Oncology (ASCO) hosted a web event on February 3, 2022 featuring oncologists, patient advocates, and policy researchers with expertise in equity and cancer care to examine persistent racial disparities in cancer. Expert panelists shared real-life experiences, provided context on the latest data, and discussed a range of actions which could help ensure that all individuals with cancer receive the highest quality, equitable cancer care and help to eliminate disparities in cancer outcomes.
State Medicaid programs are using managed care and an array of other service delivery and payment system reforms, financial incentives, and managed care contracting requirements to help achieve better outcomes and lower costs. This brief examines what delivery system and payment reform initiatives are in place across states; how are states linking financial incentives and using transparency to improve quality and outcomes; and how are states leveraging managed care plan contracts to advance delivery system and payment reform initiatives.
This Health Policy 101 chapter explores the performance of the U.S. health system on a number of cost, outcomes, and quality measures by comparing it with those in similarly large and wealthy OECD nations. It highlights that despite significant spending, Americans have shorter life expectancies and encounter more barriers to health care, influenced by both the health system's structure and broader socioeconomic factors.
Mergers and acquisitions involving hospitals and other health care providers are drawing attention from federal and state regulators, including the Federal Trade Commission, and policymakers amid concerns that such consolidations can reduce competition and contribute to the high costs of health care.
As policymakers and regulators pay more attention to consolidation in health care provider markets, this brief examines and summarizes the evidence about consolidation, including recent trends, the impact on prices and quality, and proposals to address consolidation and increase competition.
This Data Spotlight reviews national and state-level enrollment trends as of March 2016 and examines variation in enrollment by plan type and firm. It analyzes the most recent data on premiums, out-of-pocket limits, Part D cost-sharing for drugs, and plans’ quality ratings for Medicare Advantage enrollees.
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