Category: health costs

Ten Things to Know About Consolidation in Health Care Provider Markets

As policymakers and regulators pay more attention to consolidation in health care provider markets, this brief examines and summarizes the evidence about consolidation, including recent trends, the impact on prices and quality, and proposals to address…

Gross Medicare Spending on Ozempic and Other GLP-1s Is Already Skyrocketing – Even Though Medicare Cannot Cover The Drugs for Weight Loss

A KFF analysis shows that gross total Medicare spending on Ozempic and other similar drugs has increased dramatically in recent years – even though Medicare is explicitly prohibited by law from covering the drugs for obesity. That’s because Medicare no…

Medicare Spending on Ozempic and Other GLP-1s Is Skyrocketing

This policy watch analyzes the latest data on Medicare Part D spending on GLP-1 drugs, initially approved to treat diabetes but in high demand as treatments for obesity, and shows how spending on these drugs has increased substantially in recent years….

Gaps in Data About Hospital and Health System Finances Limit Transparency for Policymakers and Patients

This brief describes gaps in data about hospital and health system finances and business practices that limit transparency for policymakers, researchers, and consumers. It examines data issues involving finances, debt collection practices, charity care…

What resources are available for privately insured patients who get surprise balance bills?

Most patients do not know about the new surprise billing protections and likely also do not know of resources available to seek recourse for incorrect medical bills. This brief provides resources to privately insured patients who receive surprise balan…

Medicare Households Spend More on Health Care Than Other Households

This brief examines the financial burden of health care spending among households where all members are covered by Medicare compared to non-Medicare households.

FAQs on Prescription Drug Importation

These FAQs address questions related to prescription drug importation, including the current status of importation proposals, details of Florida’s importation program recently authorized by the FDA, and concerns and challenges with this approach.

Charges for Emails with Doctors and other Healthcare Providers

Patient-provider email messaging accelerated early in the COVID-19 pandemic as more patients sought medical care remotely, and the addition of billing codes for digital health services and subsequent changes in insurers’ payment policies have enabled p…

What to Know About How Medicare Pays Physicians

In November 2023, CMS finalized a 3.4% decrease in the physician fee schedule conversion factor, a key aspect of payment rates under the Medicare program, resulting in a 1.25% decrease in overall payments that is expected to vary by specialty. This iss…

Three Charts: The Cost and Coverage of Opill—the First FDA-approved Over-the-Counter Daily Oral Contraceptive Pill in the United States 

The first FDA-approved over-the-counter daily oral contraceptive pill in the United States— Perrigo’s Opill— is now available for pre-order at major online retailers and will soon be available in stores. Although the new over-the-counter pill could bro…