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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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2012 Employer Health Benefits Survey

This annual survey of employers provides a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing provisions, and other relevant information. The survey continues to document employer’s implementation of health reform with question on the percent of firms with grandfathered health plans and enrollment of adult children due to the new health reform law. The 2012 survey included 3,326 randomly selected public and private firms with three or more employees (2,121 of which responded to the full survey and 1,205 of which responded to an additional question about offering coverage).

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The Henry J. Kaiser Family Foundation

Managing Medicaid Pharmacy Benefits: Current Issues and Options

This report examines reimbursement, benefit management and cost sharing issues in Medicaid pharmacy programs. The analysis, conducted by researchers from the Foundation’s Kaiser Commission on Medicaid and the Uninsured and Health Management Associates, focuses on the potential of several measures recently highlighted by Health and Human Services Secretary Kathleen Sebelius…

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The Henry J. Kaiser Family Foundation

Paying a Visit to the Doctor: Current Financial Protections for Medicare Patients When Receiving Physician Services

This issue brief explains provisions in current law that shield beneficiaries from unexpected and confusing charges when they see physicians and practitioners—namely, the participating provider program, limitation on balance billing, and conditions on private contracting for doctors who opt out of Medicare or join “concierge” practices. It also analyzes the implications of modifying these provisions for beneficiaries, providers, and the Medicare program.

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The Henry J. Kaiser Family Foundation

The Cost of Care with Marketplace Coverage

This brief and accompanying slides examine cost sharing – deductibles, copayments and coinsurance – in 2015 insurance plans sold on the Affordable Care Act’s (ACA) federally-facilitated marketplaces. The analysis looks at out-of-pocket limits, as well as cost sharing for hospital stays, physician visits, emergency room visits, and prescription drugs, for plans across the metal levels (platinum, gold, silver and bronze).

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The Henry J. Kaiser Family Foundation

Cost-Sharing Subsidies in Federal Marketplace Plans

This brief and the accompanying slides examine reduction of cost sharing – deductibles, copayments and coinsurance – in the Affordable Care Act’s (ACA) federally-facilitated marketplaces. The analysis shows how cost-sharing subsidies reduce the cost of deductibles, out-of-pocket limits, physician visits, emergency room visits and prescription drug costs in silver plans for low-income people (people whose income is 250 percent of the federal poverty level or below).

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The Henry J. Kaiser Family Foundation

New Reports Analyze Cost Sharing in 2015 ACA Marketplace Plans in 37 States

Charts Examine Savings from Subsidies at Stake in U.S. Supreme Court Case Cost-sharing subsidies under the Affordable Care Act can substantially reduce deductibles and other cost sharing for people with low incomes purchasing coverage in the federally-facilitated insurance marketplace serving 37 states, a new analysis by the Kaiser Family Foundation…

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The Henry J. Kaiser Family Foundation

Consumer Assets and Patient Cost Sharing

Higher cost sharing in private insurance has been credited with helping to slow the growth of health care costs in recent years. For families with low incomes or moderate incomes, however, high deductibles, out-of-pocket limits and other cost sharing can be a potential barrier to care and may lead these families to significant financial difficulties. This issue brief uses information from the Federal Reserve Board’s 2013 Survey of Consumer Finances to look at how household resources match up against potential cost-sharing requirements for plans offered by employers or available in the individual market, including in the Affordable Care Act marketplaces.

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The Henry J. Kaiser Family Foundation

Minimum Contraceptive Coverage Requirements Clarified by HHS Guidance

New HHS clarification on ACA contraceptive coverage requirement specifies that insurance plans must cover at no cost to women all of the 18 contraceptive methods approved by the FDA.  If a provider recommends a specific option or product, plans must cover it at no cost as well. Minimum Contraceptive Coverage…

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.