Analysis Examines the Implications of Price Transparency for Providers and Patients as New Rules Go into Effect January 13, 2021 News Release A new KFF analysis examines how new federal rules on price transparency for health services may affect patient decision-making and market pricing. As of January 1, 2021, the United States Department of Health and Human Services requires that hospitals publish payer-negotiated rates for common services on their websites. A second…
Price Transparency and Price Variation in U.S. Health Services January 13, 2021 Issue Brief A new Peterson-KFF analysis examines the potential impact of new federal price transparency rules on patient decision-making and market pricing for health services. The brief also includes new analysis of geographic variation in health prices.
Pricing and Payment for Medicaid Prescription Drugs January 23, 2020 Issue Brief Attention to high list prices continues at both the state and federal levels with a number of policy proposals aimed at lowering drug prices and there is renewed interest in drug prices and reimbursement within Medicaid. Changes made in 2016 to federal rules governing how state Medicaid programs pay for drugs aimed to make the prices paid more accurate, but increased reliance on pharmacy benefit managers (PBMs) pose challenges to drug price transparency. This brief explains Medicaid prescription drug prices to help policymakers and others understand Medicaid’s role in drug pricing and any potential consequences of policy changes for the program.
Price Regulation, Global Budgets, and Spending Targets: A Road Map to Reduce Health Care Spending, and Improve Affordability May 31, 2022 Report We review several policy options to constrain health care spending, primarily by putting downward pressure on provider prices, including price regulation, global budgets, and spending growth targets.
Analysis: Inconsistencies Within Hospital Price Transparency Data Make Cost Comparisons Difficult February 10, 2023 News Release Since 2021, federal law has required hospitals to publicly post information about their standard prices and negotiated discount rates for common health services to encourage consumers to compare prices and to promote competition. To date, however, the transparency data currently shared by hospitals to comply with the law are messy,…
Ongoing Challenges with Hospital Price Transparency February 10, 2023 Issue Brief This analysis examines transparency data currently shared by hospitals to comply with federal law and finds that they are messy, inconsistent and confusing, making it challenging if not impossible for patients or researchers to use them to compare prices. Many of these shortcomings stem from a lack of specificity in the requirements for what hospitals must report.
How Much Could COVID-19 Vaccines Cost the U.S. After Commercialization? March 10, 2023 Issue Brief This analysis illustrates the potential total cost of Pfizer and Moderna COVID-19 vaccines, based on their publicly-announced expected prices, once they enter the U.S. commercial market. It compares the average price paid by the federal government for the COVID-19 bivalent boosters to the estimated average commercial prices across different scenarios.
Half of All Hospitals Have Charity Care Costs That Represent 1.4% or Less of Their Operating Expenses November 3, 2022 News Release Half of hospitals reported that the cost of providing charity care to patients represented 1.4% or less of their operating expenses in 2020, though the rates vary widely from hospital to hospital, a new KFF analysis finds. Based on a review of hospital cost report data, the analysis finds some…
Hospital Charity Care: How It Works and Why It Matters November 3, 2022 Issue Brief This issue brief examines the role that hospital charity care programs play in helping patients who are unable to afford their care. It describes how hospital charity care programs work, the amount of charity care that hospitals provide, relevant federal and state regulation, the role of Medicare and Medicaid in helping hospitals afford charity care expenses, and policy proposals related to charity care programs.