Health Policy

Enrollment in Medicare Advantage plans has increased rapidly in recent years. The share of eligible Medicare beneficiaries enrolled in MA rose from 25% in 2010 to 47% in 2021 (27.6 million enrollees). Payments to MA plans more than doubled between 2015 and 2021 (from $175 to $361 billion), taking the share of total Medicare Parts A & B spending on MA from 38% to 54%.

Prescription drug shortages are an ongoing concern in the United States (U.S.). While prior analyses explore the frequency of drug shortages in the U.S., little is known about the extent to which U.S. shortages impact consumer costs and healthcare systems. Drug shortages impact consumer costs in various ways.

Telehealth utilization has changed over time since the steep increase from the early stages of the COVID-19 pandemic. This report updates prior findings on national trends of telehealth use through an analysis using the Census Bureau’s Household Pulse Survey data from April 2021 through August 2022.

Effective January 1, 2023, the Inflation Reduction Act (IRA) eliminated enrollee cost-sharing for recommended vaccines covered under Medicare Part D. In 2021, 3.4 million people received vaccines under Part D, and annual out-of-pocket costs were $234 million.

Prescription drug price increases create affordability challenges for patients and for the government. This report tracks drug price changes from 2016-2022. There were 1,216 products whose price increases during the twelve-month period from July 2021 to July 2022 exceeded the inflation rate of 8.5 percent for that time period. The average price increase for these drugs was 31.6 percent.

Payers across the health care spectrum have begun transitioning from paying for quantity toward paying for quality. These value-based payment (VBP) programs vary in scope and focus, but generally share the goals of improving cost-savings and linking payments to value rather than volume.

This posting includes a report prepared by the RAND Corporation, “State All Payer Claims Databases Understanding the Current Landscape and Challenges to Use,” which builds on a 2021 report “The History, Promise and Challenges of State All Payer Claims Databases.” The new report provides additional detail on the objectives of and use cases for APCDs, the current APCD landscape, and implementatio

The Assistant Secretary for Planning and Evaluation (ASPE) contracted with RAND Health Care to develop methods for imputing race and ethnicity among people who selected Marketplace plans on HealthCare.gov but did not report their race or ethnicity, and to apply these methods to data from the 2015 to 2022 Open Enrollment Periods.

Telehealth services expanded rapidly during the COVID-19 pandemic. Using data from the Census Bureau’s Household Pulse Survey (HPS) in 2021, this Issue Brief analyzes national trends in telehealth utilization across all payers and examines how use of video-enabled vs. audio-only telehealth services differ across patient populations.

On January 1, 2022, the surprise billing provisions of the Consolidated Appropriations Act, 2021 - commonly referred to as the No Surprises Act - go into effect. Surprise billing occurs when a privately insured individual receives an unexpected bill either in an emergency situation or when a service in an in-network facility is provided by an out-of-network provider.