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Medicaid Managed Care in the Era of Health Reform – Briefing and Panel Discussion

Amid increasing state and national interest in using managed care delivery models for Medicaid beneficiaries, the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU) hosted a public briefing on Tuesday, June 25, 2013 to provide information on recent transitions from fee-for-service to managed care, and to discuss their…

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The Henry J. Kaiser Family Foundation

Medicare Part D Prescription Drug Plans: The Marketplace in 2013 and Key Trends, 2006-2013

This report presents findings from an analysis of the Medicare Part D marketplace in 2013 and changes in drug coverage and costs since 2006. It presents key findings related to Medicare drug plan availability, enrollment, premiums, low-income subsidies, the coverage gap, benefit design, cost sharing, formularies, and utilization management, based on data from CMS for all plans participating in Part D. The analysis was conducted jointly by researchers at Georgetown University, the Kaiser Family Foundation and the National Opinion Research Center at the University of Chicago.

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The Henry J. Kaiser Family Foundation

Medical Debt Among People With Health Insurance

This report examines the causes and contributors to medical debt, medical bankruptcy, and other difficulties with medical bills among people with insurance. Through in-depth interviews of nearly two-dozen people and quantitative analysis of national survey data, the authors of this report find that in-network and out-of-net-work cost sharing primarily contribute to medical debt among the insured.

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The Henry J. Kaiser Family Foundation

Healthier and Wealthier, or Sicker and Poorer? Prospects for Medicare Beneficiaries Now and in the Future

This January 2014 briefing, co-sponsored by the Kaiser Family Foundation and the Alliance for Health Reform, examines what is known about the health and economic security of Medicare beneficiaries today, as well as how current and future beneficiaries may be affected by the leading proposals that aim to achieve Medicare savings.

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The Henry J. Kaiser Family Foundation

Health Care Costs: A Primer

This primer on health care spending in the United States reviews the growth in health care spending since 1970 and the impact of health care costs on families and employers.

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The Henry J. Kaiser Family Foundation

Adding an Out-of-Pocket Spending Maximum to Medicare: Implementation Issues and Challenges

In an effort to simplify Medicare’s cost-sharing requirements, provide beneficiaries with catastrophic protection, and achieve program savings, some have proposed to restructure Medicare’s benefit design. Several recent proposals would create a unified deductible for Medicare Parts A and B, simplify cost-sharing requirements above the deductible, and add an annual limit on beneficiary out-of-pocket spending—a benefit feature typical of larger employer plans, but lacking in traditional Medicare. This issue brief describes the options for adding an out-of-pocket spending limit to Medicare and examines the operational issues that could arise in implementing both a uniform and an income-based out-of-pocket spending limit. Because the implementation of an income-related out-of-pocket maximum would pose somewhat greater complexity for Medicare, the operational issues associated with this approach are discussed in greater detail.

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The Henry J. Kaiser Family Foundation

Employer-Sponsored Family Health Premiums Rise a Modest 4 Percent in 2013, National Benchmark Employer Survey Finds

Annual premiums for employer-sponsored family health coverage reached $16,351 this year, up 4 percent from last year, with workers on average paying $4,565 toward the cost of their coverage, according to the Kaiser Family Foundation/Health Research & Educational Trust (HRET) 2013 Employer Health Benefits Survey. This year’s rise in premiums remains moderate by historical standards. The 15th annual Kaiser/HRET survey of more than 2,000 small and large employers provides a detailed picture of the status and trends in employer-sponsored health insurance costs and coverage.

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The Henry J. Kaiser Family Foundation

Questions About Essential Health Benefits

The Institute of Medicine (IOM) recently issued its long-awaited report on defining the essential health benefits under the Affordable Care Act (ACA). As expected, the committee preparing the IOM report did not recommend which specific services should be covered, but rather discussed what the process should be for defining the essential benefits,…

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The Henry J. Kaiser Family Foundation

Testimony: Rethinking Medicare’s Benefit Design: Opportunities and Challenges

Foundation Senior Vice President Tricia Neuman testified June 26, 2013 before the House Energy and Commerce Committee Subcommittee on Health about Medicare’s benefit design, and the implications of possible changes for beneficiaries, other stakeholders, and program spending.

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The Henry J. Kaiser Family Foundation

Explaining Health Reform: Benefits and Cost-Sharing for Adult Medicaid Beneficiaries

This brief provides details of the benefit and cost-sharing rules that will govern the coverage available under health reform to these newly eligible adults Medicaid beneficiaries, and it identifies key considerations for state policymakers making Medicaid benefit design choices.

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