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Beyond the Data: Are the Tradeoffs from Prior Authorization Worth It? 

In his latest column, President and CEO Dr. Drew Altman asks if prior authorization review could be eliminated entirely, discussing how it might be done and the tradeoffs. He writes “Nothing makes American health care consumers more frustrated using the health system than prior authorization review. I know because they told us that, ranking prior authorization review far ahead of any other problems they have getting care and navigating the health care system, including getting appointments and understanding their bills.”

Affordable care act

ACA Marketplace Survey Feature Image - Website

Cost Concerns and Coverage Changes: A Follow-Up Survey of ACA Marketplace Enrollees

This KFF survey is a follow-up survey of adults who had ACA Marketplace insurance in 2025. The survey examines the cost concerns and coverage changes that these 2025 Marketplace enrollees are experiencing following the expiration of the enhanced premium tax credits. The survey finds that half of returning enrollees say their health care costs are “a lot higher” and most expect to cut back on basic household expenses to afford coverage.

Health System Tracker

How Does Health Spending in the U.S. Compare to Other Countries? While the U.S. still spends the most in total dollars, eight OECD nations had a higher percentage increase in per-person health spending in 2024.

 

How Does Cost Affect Access to Health Care? In 2024, about 1 in 6 adults reported delaying or not getting healthcare due to cost, including medical or mental health care.

 

How Do Health Expenditures Vary Across the Population? Five percent of the population made up nearly half of all health spendings, pending an average of $72,918 annually in 2023.

NHE explorer

National Health Spending Explorer: Get up-to-date information on U.S. health spending by federal and local governments, private companies, and individuals.

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  • Impact of Direct-to-Consumer Advertising on Prescription Drug Spending

    Report

    A new study by researchers at Harvard University and the Massachusetts Institute of Technology looks at the effect of direct-to-consumer (DTC) advertising on spending for prescription drugs. The study found that, on average, a 10% increase in DTC advertising of drugs within a therapeutic drug class resulted in a 1% increase in sales of the drugs in that class.

  • Demand Effects of Recent Changes in Prescription Drug Promotion

    Report

    The rapid increase in DTC advertising for prescription drugs has focused attention on its role in drug spending and prescribing. A new study by researchers at Harvard University and the Massachusetts Institute of Technology looks at the effect of direct-to-consumer (DTC) advertising on spending for prescription drugs.

  • Medicare Cost-Sharing: Implications for Beneficiaries

    Event Date:
    Event

    Tricia Neuman, Vice President and Director of the Medicare Policy Project, testified on behalf of herself and Thomas Rice, Ph.D., of UCLA's School of Public Health, before the House Ways and Means Subcommittee on Health on cost-sharing requirements under Medicare and supplemental Medigap policies.

  • How Do M+C Plans Manage Pharmacy Benefits? Implications for Medicare Reform

    Report

    Understanding how Medicare+Choice (M+C) plans manage their drug benefits may generate important lessons for Medicare. This report, based on interviews with both national and regional managed care firms, provides an in-depth look at how plans have managed their M+C outpatient pharmacy benefits in recent years.

  • The Development of Direct-to-Consumer Prescription Drug Advertising Regulation

    Other Post

    This article, which appears in the Food and Drug Law Journal, vol. 57, no. 3, 2002, pp. 423-444 was based on a report written by F.B. Palumbo and C.D. Mullins at the University of Maryland School of Pharmacy Center on Drugs and Public Policy and funded by the Kaiser Family Foundation.

  • Regulation of Private Long-Term Care Insurance: Implementation Experience and Key Issues

    Report

    Regulation of Private Long-Term Care Insurance: Implementation Experience and Key Issues While private long-term care insurance (LTCI) has been available since the mid-1970s, its popularity has grown rapidly in recent years, and Congress is considering proposals that would further encourage LTCI purchase through expanded tax subsidies.

  • Private Long-Term Care Insurance:  Who Should Buy It and What Should They Buy?

    Report

    Private Long-Term Care Insurance: Who Should Buy It and What Should They Buy? Despite the growing interest in private long-term care insurance (LTCI), there has been little independent examination of how much protection LTCI policies provide consumers or whether LTCI policies are a worthwhile purchase for people of average means.