Prescription Drugs

This fact sheet summarizes Medicaid’s role as the major source of outpatient pharmacy services for low-income Americans. Medicaid spent $25.4 billion on prescription drugs in fiscal year 2009, and outpatient prescription drug coverage is an optional benefit that all state Medicaid programs currently provide. Fact Sheet (.pdf)

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…

This Kaiser Family Foundation study examines how the coverage gap in Medicare’s drug benefit known as the “doughnut hole” affects Medicare beneficiaries and their prescribing patterns. Based on actual claims data from 2008 and 2009, before the 2010 health reform law began to close the gap, the study finds that…

As Congress and the Administration increasingly focus on the nation’s budget deficit, many policy experts and several bipartisan deficit reduction panels have proposed significant changes to Medicare to reduce federal spending and address rising health care costs. This primer provides an overview of Medicare spending trends, how the program is…

New: Medicare Advantage Plan Star Ratings and Bonus Payments in 2012 In 2012, Medicare Advantage plans will be awarded additional payments based on their quality ratings as a result of the 2010 health reform law. The Centers for Medicare and Medicaid Services has proposed a demonstration that would modify the…

Employer-provided health insurance is the primary source of insurance coverage in the United States, covering almost 160 million people.1 About 90 percent of the non-elderly privately-insured population is covered by employer-sponsored plans, meaning that employer decisions about whether to offer health benefits will influence overall rates of insurance coverage in the…

This chartbook provides the most recent and reliable data available about the Medicare program and the 47 million seniors and younger people with disabilities who get health insurance coverage through the program. Topics covered include: Medicare beneficiaries; the program’s benefits, utilization, and access to care; prescription drugs; the Medicare Advantage…

  This Medicare Advantage Data Spotlight provides an overview of recent changes made to the Medicare Advantage program and examines trends in plan participation, premiums and certain benefits. About 12 million people, or nearly a quarter of the Medicare population, are enrolled in Medicare Advantage, the privately administered plans that…

This initial analysis examines the private stand-alone Part D drug plans will be available to Medicare beneficiaries in 2011 and provides an early look at key trends in the options, premiums, and other plan characteristics. It finds that the average Medicare beneficiary will have a choice of 33 Part D…

Most Americans receive their health insurance through their own job or the job of a family member; an offer of coverage at work is an important determinant of the likelihood of having private health insurance. This analysis examines the percentage of nonelderly, full-time adult workers (age 18 through 64) in…