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Prior Authorization Metrics Provide New Insights into Insurer Practices, but Gaps Remain

This analysis of available 2025 prior authorization data finds insurers denied at least 1 in 8 standard requests for prior authorization across three insurance markets: Medicare Advantage, Medicaid managed care, and the federally facilitated ACA Marketplaces. Denial rates varied wide segments by insurer. The analysis highlights limitations of the data and challenges for consumers interpreting it.

TrumpRx: What’s the Value for Customers?

In February, the Trump administration launched TrumpRx, a government website that provides prescription drug discounts to consumers. This brief examines issues that may impact consumers, especially those with private insurance, who access drug discounts through TrumpRx.

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  • Employers Attitudes Toward Patients Rights

    Report

    A national survey of employers, released jointly by the Kaiser Family Foundation and the Health Research and Educational Trust, found that smaller employers (3 to 199 employees) are significantly more likely than larger employers (200 or more employers) to support a person's right to sue a health plan, and somewhat more likely to support the right to appeal a health plan's decision to an independent reviewer. Two-thirds (67%) of smaller employers express support for the…

  • Comparison of State Managed Care Liability Laws

    Report

    Since Texas enacted the first law explicitly authorizing suits by enrollees in health plans offered by managed care organizations (MCOs) and other insurers, several other states have adopted similar legislation. This report, prepared by Patricia Butler, J.D., Dr.Ph., for the Kaiser Family Foundation, briefly describes the key features of these state laws, legal challenges that have been raised to some of them, and early experiences in states whose laws are in effect. The key features…

  • Health News Index – May/June 2001

    Poll Finding

    Health News Index May/June, 2001 The May/June 2001 edition of the Health News Index includes questions about major health stories covered in the news, including the Supreme Court ruling regarding the distribution of medical marijuana and the debate in Congress over a Patients Bill of Rights. This edition also includes findings on public support for certain prescription allergy medicines being sold over the counter. The Health News Index is designed to help the news media…

  • Recent Attitudes Towards Patients Rights and Managed Care

    Report

    Newly released survey findings show continued public support for patient protections, including the right to sue health plans, but that support erodes if people believe that the cost of health insurance may increase or that companies might stop offering health coverage to their workers. The survey found that the percentage of people reporting problems with their health plans and the urgency the public attaches to Congressional action has not changed in recent years. Public Opinion…

  • National Survey on Americans as Health Care Consumers: An Update on the Role of Quality Information

    Poll Finding

    This survey of Americans by the Kaiser Family Foundation and the Agency for Health Care Research and Quality (AHRQ) shows that the recent attention to medical errors may have entered the public's consciousness since it is now among the public's leading measures of health care quality. The survey also found that the public is more likely to rely on recommendations of friends, family and health professionals they know than on existing standardized quality indicators. Few…