Quality performance metrics such as HEDIS, Medicare Advantage Star Ratings, and standardized core quality measures can give consumers an indication of healthcare payer quality.
Standardized quality...
Around half of Medicare Advantage beneficiaries disenrolled from their health plan after five years, a study published in JAMA Health Forum found.
Capitated payments to Medicare Advantage plans aim to...
CMS has identified system errors that may unnecessarily disenroll eligible Medicaid and Children’s Health Insurance Program (CHIP) enrollees during the redetermination process and is calling on...
Updated 10/3/2023: This article has been updated to include the drug companies' decisions to participate in the negotiation process.
HHS has announced the first ten drugs that will be available...
Millions of Medicaid enrollees have been disenrolled from Medicaid during the redetermination process, largely for procedural reasons, a KFF tracker noted.
As of August 23, 2023, over 5.36 million...
Medicare Advantage plans received generally positive satisfaction scores, with beneficiaries giving high ratings on trust, ease of doing business, and meeting product and coverage needs, according to a...
CMS has released draft guidance detailing a new program allowing Medicare beneficiaries to pay out-of-pocket Part D costs in monthly installments.
The Medicare Prescription Payment Plan is required...
As obesity treatments become more popular, Medicaid plays a key role in facilitating access to and coverage of these services for children, according to a KFF issue brief.
Obesity can increase the...
Even as inflation seems to be plunging from its peak, the ongoing pressure from high medical costs is set to push ACA Marketplace premiums up to an average of 6 percent in 2024, according to...
Medicare Part D premiums are projected to decrease from $56.49 in 2023 to $55.50 in 2024, CMS announced.
The projected average Part D premium represents the sum of the average basic premium and the...
Individuals were more likely to receive breast cancer and colorectal cancer screenings after obtaining Medicare coverage, according to a study from Epic Research.
The Affordable Care Act requires...
Almost four months after the Medicaid continuous enrollment provision ended, CMS has paused coverage redeterminations in at least six states.
In a press call on July 19, CMS Administrator Chiquita...
The Centers for Medicare and Medicaid Services (CMS) has approved proposals to expand behavioral health services for Medicaid beneficiaries in California and Kentucky through community-based mobile...
Psychiatrist networks in Medicare Advantage plans are narrower than those in Medicaid managed care and Affordable Care Act (ACA) plans, according to a study published in Health Affairs.
As demand for...
The ten top-selling prescription drugs accounted for more than 20 percent of total gross Medicare Part D spending in 2021, a KFF analysis revealed.
Under the Inflation Reduction Act’s Medicare...
Medicaid beneficiaries with late-stage cancer might have greater access to palliative care in states that have adopted Medicaid expansion, a study published in Health Affairs found.
The researchers...
The Medicare Advantage quality bonus program overpays plans and does not effectively promote quality care, indicating that program reforms are needed, according to an Urban Institute report.
The...
Limited English proficiency (LEP) can significantly stunt a patient’s ability to communicate with doctors and receive care, which results in broader care disparities along racial and ethnic...
Enrollees in California’s Affordable Care Act marketplace were less likely to experience financial barriers in 2021 compared to 2017 due to provisions in the American Rescue Plan Act (ARPA) that...
Medicare Advantage beneficiaries with chronic conditions had lower healthcare spending and fewer emergency room visits than fee-for-service (FFS) beneficiaries, according to a report from Avalere...
