Medicare

Addressing the cost of insulin continues to be at the forefront of policy discussions around prescription drugs. This analysis describes out-of-pocket spending on insulin products by Medicare beneficiaries enrolled in Part D drug plans, along with state-level use and spending data.

The brief provides a quick explainer of the prescription drug provisions in legislative text released by the Senate Finance Committee to be included in a forthcoming reconciliation bill and presents new estimates on how many Medicare beneficiaries could be helped by those provisions.

Total spending among traditional Medicare beneficiaries fell in 2020, the first year of the COVID-19 pandemic, corresponding to lower service use across most types of Medicare-covered health care services compared to 2019. The lower spending in traditional Medicare contributed to the relatively slower growth in Medicare spending overall in 2020.

Medicare spending for skilled nursing facilities increased in 2020 despite an overall decrease in the number of Medicare beneficiaries using SNF services. The higher spending is explained by longer and more expensive SNF stays in 2020 compared to 2019, both of which increased more sharply for Medicare beneficiaries under the age of 65 than for older Medicare SNF users.

U.S. prescription drug spending per person is about double what it is in peer countries and about 8 in 10 U.S. adults say the cost of prescription drugs is unreasonable. With the public ranking lowering out-of-pocket costs for prescription drugs the top health care priority for Congress, lawmakers have been…

This post explains what’s known about how insurers use prior authorization as a tool to control costs and encourage cost-effective care, the state and federal laws that govern it, and ongoing policy debates over efforts to impose standards to limit or regulate its use.

Despite occasional anecdotal reports of people having trouble finding a doctor who takes their insurance, KFF researchers find in a new analysis that the vast majority of non-pediatric office-based physicians accept new Medicare patients, as well as new private insurance patients. Eighty-nine percent of such physicians accepted new Medicare patients…

This brief examines the share of non-pediatric office-based physicians accepting new patients with Medicare or private insurance and how these rates have changed over time and vary by physician specialties, geographic areas, and physician and practice characteristics across Medicare and private insurance. This analysis further examines the extent to which non-pediatric physicians are opting out of Medicare, by specialty and state.

Medicare premiums and cost sharing will account for an increasing share of Social Security benefits in the future, Medicare Trustees project.

A new KFF interactive provides essential facts and trends about spending on Medicare, the federal health insurance program that covers 65 million seniors and people with disabilities, or nearly 1 in 5 Americans. In 2020, Medicare spending accounted for 12 percent of the federal budget and 20 percent of national…