Why Medicare’s Aduhelm Coverage Decision Could Increase Pressure on Officials to Roll Back the Record Part B Premium Increase for 2022 January 14, 2022 News Release In a new Policy Watch, KFF experts explain why Medicare’s preliminary decision to cover a new Alzheimer’s drug only for a limited group of beneficiaries is likely to intensify pressure on officials to reconsider the increase in the Medicare Part B premium for 2022. Earlier this week, CMS issued a…
Medicare’s Coverage Decision for the New Alzheimer’s Drug and Why It Matters January 14, 2022 Blog This policy watch discusses the implications of Medicare’s preliminary National Coverage Determination for the new Alzheimer’s drug, Aduhelm, on the 2022 Medicare Part B premium and the possibility of an adjustment based on the coverage decision. The piece also discusses the implications for Medicare spending and the connection to ongoing policy discussions around prescription drug proposals in the Build Back Better Act.
Assessing Online Availability of At-Home COVID-19 Tests Ahead of Private Insurance Reimbursement January 13, 2022 Issue Brief This data note explores findings from on an 8-day online search for at home COVID-19 tests at major retailers. The findings are described against the backdrop of the Biden Administration policy requiring plans to cover the cost of these tests. We find that these tests remain hard to find and that this limited availability could negatively affect the success of the reimbursement strategy.
States Reporting Medicaid Managed Care Requirements for Alternative Provider Payment Models (APMs) January 12, 2022 State Indicator
Performance Measure Focus Areas for Medicaid Managed Care Incentives January 12, 2022 State Indicator
State Delivery System and Payment Strategies Aimed at Improving Outcomes and Lowering Costs in Medicaid January 12, 2022 Issue Brief State Medicaid programs are using managed care and an array of other service delivery and payment system reforms, financial incentives, and managed care contracting requirements to help achieve better outcomes and lower costs. This brief examines what delivery system and payment reform initiatives are in place across states; how are states linking financial incentives and using transparency to improve quality and outcomes; and how are states leveraging managed care plan contracts to advance delivery system and payment reform initiatives.
Monthly Part B Premiums and Annual Percentage Increases January 12, 2022 Slide The $21.60 increase in 2022 is the largest in dollar terms since the start of the program, even though premiums have risen faster in percentage terms on three other occasions in the last 20 years
Before New Ban, the Prevalence of Surprise Bills January 7, 2022 Slide Patients with certain conditions appear to be at higher risk for receiving surprise bills. They should be aware of new federal protections against surprise bills and know how to seek out help if they have improperly received one.
‘In Focus with KFF’: What to Know About the New Ban on Surprise Bills January 5, 2022 Video In this new video, KFF Senior Fellow Karen Pollitz explains why surprise bills have been such a major problem for patients, the new federal ban on the practice, and how patients can get help if they received a surprise bill.
Household Health Spending Calculator January 1, 2022 Interactive People generally think of their health spending as the amount paid for monthly premium contributions, as well as any out-of-pocket costs toward medical care or prescription drugs. However, a significant portion of health spending is not as visible to people in their everyday lives. This less direct health spending includes…