Medicare Advantage Insurers Report Much Higher Gross Margins Per Enrollee Than Insurers in Other Markets February 28, 2023 News Release A new analysis of health insurers’ 2021 financial data shows that insurers continue to report much higher gross margins per enrollee in the Medicare Advantage market than in other health insurance markets. The analysis examines insurers’ financial data in the Medicare Advantage, Medicaid managed care, individual (non-group), and fully insured…
Many Women Use Preventive Services, but Gaps in Awareness of Insurance Coverage Requirements Persist: Findings from the 2022 KFF Women’s Health Survey February 22, 2023 Issue Brief This brief presents findings from the 2022 KFF Women’s Health Survey on women’s receipt of cancer screenings and other preventive services and differences between subgroups of women. We also present data on women’s and men’s awareness of federal requirements for private insurance coverage of preventive services.
CMS Prior Authorization Proposal Aims to Streamline the Process and Improve Transparency February 21, 2023 Issue Brief This brief explains a new proposed federal regulation aimed at reducing administrative hassles involved in obtaining prior authorization for care and sets out key policy questions, including how the proposal could impact the patient experience and data privacy.
Claims Denials and Appeals in ACA Marketplace Plans in 2021 February 9, 2023 Issue Brief This analysis of HealthCare.gov Marketplace insurers’ transparency data finds that 17% of in-network claims were denied in 2021, with denial rates varying widely across insurers. Consumers appealed less than two-tenths of 1% of denied in-network claims.
How Will the Prescription Drug Provisions in the Inflation Reduction Act Affect Medicare Beneficiaries? January 24, 2023 Issue Brief The brief provides a quick explainer of the prescription drug provisions in the Inflation Reduction Act signed into law on August 16, 2022 and presents new estimates on how many Medicare beneficiaries could be helped by those provisions.
Recent Studies Show That Medicaid Expansion Has Improved the Financial Performance of Hospitals and Other Providers, In Line With Prior Research January 18, 2023 News Release A KFF synthesis of recent studies finds that Medicaid expansion has been beneficial to the finances of hospitals and providers, driving decreases in the share of uninsured patients, increases in Medicaid-covered patients and declines in uncompensated care. By financing coverage for low-income people who are likely to otherwise be uninsured,…
What Does the Recent Literature Say About Medicaid Expansion?: Economic Impacts on Providers January 18, 2023 Issue Brief This issue brief updates prior KFF literature reviews by summarizing 24 studies published between April 2021 and December 2022 on the economic impact of Medicaid expansion on providers.
About 5 Million Uninsured People Could Get ACA Marketplace Coverage Without a Monthly Premium – But They Would Have to Enroll Soon January 10, 2023 News Release About 5 million uninsured people across the country could get coverage through an Affordable Care Act Marketplace health plan with virtually no monthly premium if they enroll soon, a new KFF analysis finds. In most states, open enrollment runs through January 15, with tax credits available to help eligible low-…
Millions of Uninsured People Can Get Free ACA Plans January 10, 2023 Blog This post estimates that about 5 million uninsured people across the country could get coverage through an Affordable Care Act (ACA) Marketplace health plan with virtually no monthly premium if they enroll during the 2023 open enrollment period, which runs through Jan. 15 in most states.
Medicaid as a Potential New Third Rail of US Politics December 22, 2022 Perspective In this JAMA Forum column, KFF’s Larry Levitt examines Medicaid’s growing political importance and the potential double whammy that could hit state Medicaid programs next year with the end of the COVID-19 public health emergency and a possible simultaneous recession.