The federal government has proposed new rules that aim to make Medicaid outpatient drug reimbursement policies more closely match the cost of obtaining and filling prescriptions. However, the change in policy may have varying effects on reimbursement, depending on the state’s current approach and the type of drug in question. This paper explains current Medicaid pharmacy reimbursement methodology and examines the potential effect of the proposed rule changes.
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This blog post discusses Sovaldi (sofosbuvir), an oral drug recently approved by the FDA for the treatment of chronic hepatitis C, and the potential impact of this long-awaited cure on Medicare spending and Part D premiums.
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.
Health spending growth has consistently outpaced U.S. economic growth and is higher than medical spending in other wealthy countries. Despite spending more, the United States doesn’t have better health outcome in terms of life expectancy, mortality rates and other measures. This brief provides an overview of trends in health costs and the performance of the U.S. health system, including comparisons to countries from the Organisation for Economic Co-operation and Development (OECD). The brief charts growth in the nation’s per capita health spending along with the recent slowdown, touching on the roles of expanded Medicaid eligibility, increases in Medicare beneficiaries and the Affordable Care Act (ACA). Additionally, it discusses the health system’s effectiveness and capacity to provide services, including the accessibility and affordability of care.
The Kaiser Family Foundation, in partnership with the Peterson Center on Healthcare, today announced a new online hub dedicated to monitoring and assessing the performance of the U.S. health system. The Peterson-Kaiser Health System Tracker provides comprehensive data on how the system is performing on critical quality and cost measures,…