CMS recently issued a statement saying that it's continuing the Medicare Drug Price Negotiation Program but is leaving the door open for potential changes. Experts weighed in on what changes could be made and what changes they would like to see.
About one in five in-network claims were denied by insurers of qualified health plans on HealthCare.gov in 2023, according to KFF. There is also wide variation by insurer and state.
Discover Houston's best orthopedic surgery centers and what features — from personalized treatment plans to rehabilitation services — make these top providers stand out in their industry.
In the 2024 election, seven out of 10 states passed ballot measures protecting abortion rights. But the effects won't be seen immediately, experts say.
About 7.4% of prior authorization requests submitted to MA insurers were denied in 2022, according to a recent KFF report. Of these denials, only 9.9% were appealed.
A new KFF report detailed the growth in Medicare Advantage's share of total inpatient hospital days.
The Federal Trade Commission recently released an interim report that details how the practices of pharmacy benefit managers negatively impact patients and pharmacies. Some experts hope for legislative action based on the report.
Employees who enjoy their benefits are more inclined to stay with their company. A 2025 Marsh McLennan Agency report said 73% of employees would remain if plan options were better.
One year after the Medicaid continuous enrollment provision ended, 19.2 million people have been disenrolled from Medicaid, according to KFF. This is higher than many expected, and experts have mixed reviews on how they think this process has gone.
Only 8% of large employers have reduced or expanded their coverage for abortion after the Dobbs v. Jackson decision, a new report from KFF found.
AI can improve the prior authorization process, but there needs to be more transparency, experts said during a recent panel held by KFF.
A new KFF report analyzed recent trends in Medicaid outpatient prescription drug utilization and spending. It discovered that although there's been lower utilization of prescription drugs in recent years, Medicaid spending on prescription drugs has increased.
The layout of your phlebotomy station can significantly impact efficiency. A well-thought-out setup ensures that every tool is within reach, minimizing unnecessary movement and reducing patient wait times.
Of those with employer-sponsored insurance, 31% of lower-income adults reported having trouble paying their medical bills, versus 13% of higher-income adults, according to a new report from KFF.
A higher share of Medicaid beneficiaries rate their physical and mental health as fair or poor compared to adults with Medicare, employer-sponsored insurance or Marketplace coverage, according to a new KFF report. However, 83% of Medicaid enrollees gave their health insurance a positive rating.
New KFF focus groups revealed that some thought the process of renewing Medicaid coverage during the unwinding of the continuous enrollment provision was simple. Others, however, faced challenges with communication from state Medicaid agencies, and some weren't aware their coverage had been terminated.
In total, there are 3,959 Medicare Advantage plans being offered for individual enrollment in 2024, a 1% decrease from 2023, according to a new report from KFF.
Amid the unwinding of the continuous enrollment provision, more than 10 million people have lost Medicaid coverage, according to data from KFF. Of those disenrolled from Medicaid coverage, 71% were removed from coverage for procedural reasons.