What Steps Are Washington Policymakers Pursuing to Control Medicare Prescription Drug Spending? August 1, 2019 News Release As policymakers in Washington discuss ways to curb the rising cost of prescription drugs, KFF has released a summary and analysis of proposals and recently finalized initiatives that affect Medicare prescription drug spending. Medicare, the federal health program that covers more than 60 million seniors and younger people with disabilities,…
A Small Group of Patients Account for a Whole Lot of Spending July 29, 2019 Perspective You have heard about the 5% of the population responsible for 50% of spending. Meet the 1.3%–persistent high spenders with very complex medical needs responsible for 20%. Drew Altman discusses this and possible ways to help them, read the Axios column.
Explainer Video Breaks Down Prescription Drug Rebates and Why They Matter in the Debate About Prescription Drug Costs July 26, 2019 News Release A new KFF animation explains how rebates for prescription drugs work, including how they are determined, who benefits from them, how they affect spending by insurers and consumers and the role of pharmacy benefit managers in the process. The Trump Administration had proposed banning such rebates in Medicare Part D,…
Prescription Drug Rebates, Explained July 26, 2019 Video This animation explains how rebates for prescription drugs work and why they matter in the debate about lowering drug costs. The video breaks down how prescription drug rebates are determined, who benefits from them, how they affect spending by insurers and consumers and the role of pharmacy benefit managers in…
How Many Medicare Part D Enrollees Had High Out-of-Pocket Drug Costs in 2017? June 21, 2019 Issue Brief The Medicare Part D prescription drug benefit has helped improve the affordability of medications for people with Medicare. Yet Part D enrollees can face relatively high out-of-pocket costs because the Part D benefit does not have a hard cap on out-of-pocket spending. This analysis presents the latest data on out-of-pocket drug spending among Medicare Part D enrollees without low-income subsidies who have costs above the catastrophic coverage threshold.
10 Things to Know About Medicare Part D Coverage and Costs in 2019 June 4, 2019 Issue Brief The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans. This analysis provides the latest data about Medicare Part D coverage and costs in 2019 and trends over time, including enrollment, premiums, cost sharing, and participation in the low-income subsidy program.
New Analysis Compares Prescription Drug Spending and Use Across Large Employer Plans, Medicare, and Medicaid May 20, 2019 News Release As policymakers debate how to address the high cost of prescription drugs, a new KFF analysis compares data on prescription drug spending and use across large employer plans, Medicare Part D and Medicaid, and provides context for policy discussions about different approaches to curb rising drug costs that would affect…
How Does Prescription Drug Spending and Use Compare Across Large Employer Plans, Medicare Part D, and Medicaid? May 20, 2019 Issue Brief Prescription drug costs are a pressing concern for both consumers and policymakers. This analysis compares prescription drug spending and use in large private employer plans, Medicare Part D, and Medicaid, based primarily on claims data by payer, which does not account for rebates.
Do People Who Sign Up for Medicare Advantage Plans Have Lower Medicare Spending? May 7, 2019 Issue Brief The analysis finds that people who switched from traditional Medicare to Medicare Advantage in 2016 had health spending in 2015 that was $1,253 less, on average, than the average spending for beneficiaries who remained in traditional Medicare (after adjusting for health risk). The findings suggest that the current payment method may systematically overestimate expected costs of Medicare Advantage enrollees. Adjusting payments to reflect Medicare Advantage enrollees’ prior use of health services could potentially lower total Medicare spending by billions of dollars over a decade.
Medicaid’s Prescription Drug Benefit: Key Facts May 1, 2019 Fact Sheet Medicaid provides health coverage for millions of Americans, including prescription drug coverage for many people with substantial health needs. This fact sheet provides an overview of Medicaid’s prescription drug benefit and recent trends in spending and utilization