Study used 3 years of data published by CMS to examine the characteristics of Medicare Advantage contracts with high disenrollment rates from 2015 to 2017 and the relationship between disenrollment rates in MA contracts and 6 patient experiences of care performance measures.

Infographic presents the status of ACA 1332 waivers granted or in process for each state.

The National Academy for State Health Policy (NASHP) and The John A. Hartford Foundation are excited to offer state policymakers an informative, day-long summit designed to improve access to and quality of palliative care services in their states, followed by ongoing support and expertise. The Palliative Care State Policymaker Summit, on Tuesday, Aug. 20, 2019, in Chicago, will bring together teams of state officials from up to 10 states for information sharing, discussion, and problem solving related to palliative care policies and programs. Applications are due May 23, 2019.

This report, which describes the Congressional Budget Office’s updated baseline projections, provides estimates for the 2019–2029 period of the number of noninstitutionalized civilians under age 65 with health insurance and the federal costs associated with each kind of subsidy.

Brief offers a comprehensive look at state regulation of short-term plans, a better understand emerging trends in regulation of the short-term market, and lessons learned in the policymaking process.

Brief examines the work of five state innovation model (SIM) states to develop common measure sets that align quality measures across private and public payers—a strategy aimed at reducing administrative burdens on providers and giving focus to quality improvement efforts.

This study employed a unique approach designed to emulate consumers’ real-world experience of trying to schedule needed healthcare. Using six common, non-emergency medical scenarios, researchers tested six highly ranked healthcare transparency tools with real consumers and evaluated their ability to navigate the tools to get desired information.

Brief presents examples of consumers having a positive impact on the health system. (Center for Consumer Engagement in Health Innovation)

In 2017, Change Healthcare introduced its inaugural study, which highlighted state governments’ efforts to explore and implement VBC and reimbursement models. This study provides a state-by-state update of subsequent progress made in the past 18 months. (Change Healthcare)

A new proposed rule would update Medicare payment policies for hospitals under the Inpatient Prospective Payment System and the Long-Term Care HospitalProspective Payment System by proposing changes to the way Medicare pays hospitals.

The authors analyze the possibility of convincing more Medicaid insurers to participate in the marketplaces and the impact that would have on lowering marketplace premiums. The findings come from interviews with Medicaid managed care organization leaders and help explain why some potential participants in Medicaid managed care have been reluctant to offer coverage on ACA marketplaces.

Report highlights examples from around the country and in California of promising payment models that provide greater flexibility, tie payment more closely to quality, and give FQHCs the ability to reap financial rewards from improving quality and reducing utilization costs across the larger health care system.

In this week’s episode of On the Evidence, the host and guests discuss a major question surrounding health care reform: What do we do about the small share of patients who represent a much larger share of overall health care use and costs?

This report disaggregates Medicare Advantage enrollment growth by plan type and geography to better understand variation in the growth of Medicare private plans and explores county-level market and demographic changes associated with increased MA penetration.

On April 23, 2019, the Centers for Medicare & Medicaid Services (CMS) proposed a rule that focuses the agency’s efforts on a singular objective: transforming the healthcare delivery system through competition and innovation to provide patients with better value and results. These policies would support the agency’s priority of “Rethinking Rural Health” and help guarantee people living in rural America have access to high quality, affordable healthcare. This fact sheet discusses major provisions of the proposed rule.

Yesterday, the Medicare Board of Trustees released their annual report for Medicare’s two separate trust funds -- the Hospital Insurance (HI) Trust Fund, which funds Medicare Part A, and the Supplementary Medical Insurance (SMI) Trust Fund, which funds Medicare Part B and D.

New Mexico Gov. Lujan Grisham recently signed into law SB 131, establishing a state Interagency Pharmacy Purchasing Council to leverage public purchasing power by reviewing and coordinating cost-containment strategies through procurement of pharmaceuticals, pharmaceutical benefits, and pooling of risk among state agencies.

This policy brief continues the RUPRI Center series that updates enrollment of rural beneficiaries in Medicare Advantage plans.

CMS today released the final annual Notice of Benefit and Payment Parameters for the 2020 benefit year, also known as the 2020 Payment Notice. The rule reduces user fees for plans offered on HealthCare.gov, and encourages the use of lower-cost generic drugs, while improving market stability and consumer choice.

During the 2019 open enrollment period, we saw enrollment trend differences between the 34 states that use the federally run marketplace and the 17 state-based marketplaces. The U.S. Department of Health and Human Services reported a nearly 4 percent decline in plan selections in the federally facilitated marketplace in 2019, but overall plan selections reported by state-based marketplaces stayed steady.

Brief uses information from the Current Population Survey to look at the average amounts and the shares of family income people in working families with employer-based coverage pay out-of-pocket toward their premiums and direct payments for medical care.

This paper highlights some of the collaborative state-based purchasing approaches based on discussions with state leaders.

This report focuses on several state purchasing strategies designed to achieve concessions in negotiations with drug manufacturers and in other parts of the prescription drug supply chain.

On April 8, 2019, the Maryland General Assembly passed legislation that which would create the first state Prescription Drug Affordability Board (PDAB) to address the costs of certain high-priced drugs in Maryland. Gov. Larry Hogan has until May 31, 2019, to sign or veto the bill. If he signs the bill or does nothing, the measure will take effect on July 1, 2019.

As of April 2019, 14 states have not adopted the ACA Medicaid expansion. Across all non-expansion states, 4.4 million uninsured nonelderly adults would become eligible for Medicaid if all opted to expand their programs. The two-page fact sheets provide a snapshot with key data for those who would become eligible for Medicaid under expansion in non-expansion states.

Issue brief outlines why strong Medicaid management matters and the key attributes needed for that management.

Four panelists discuss "Medicare for All" in this podcast.

A new issue brief outlines the universal health care systems of other countries.

Based on the Small Area Health Insurance Estimates (SAHIE), over 1/3 of all US Counties had an uninsured rate of below 10% in 2017.

This issue brief presents Medicaid HCBS enrollment and spending data from the Kaiser Family Foundation’s 17th annual state survey.

This issue brief presents the latest data and answers key questions about HCBS waiver waiting lists from the Kaiser Family Foundation’s 17th annual survey of state Medicaid HCBS programs.

This issue brief presents the latest data (2017) from the Kaiser Family Foundation’s 17th annual survey of Medicaid HCBS program policies in all 50 states and DC.

This brief uses data from the Commonwealth Fund 2018 National Survey of Federally Qualified Health Centers to compare the experiences of health centers in states that have and have not expanded Medicaid.

On March 28, 2019, the D.C. federal district court set aside the Health and Human Services (HHS) Secretary’s approval of Medicaid waivers with work and reporting requirements and other eligibility and enrollment restrictions in Kentucky and Arkansas. While these cases play out in the courts, HHS has approved similar work requirement waivers in seven other states, while six states’ requests are pending as of April 1. The Trump Administration also proposed a legislative change to condition Medicaid on work and reporting requirements in all states in its budget for fiscal year 2020. For context as this all develops, KFF asked MaryBeth Musumeci, Associate Director at the Program on Medicaid and the Uninsured, three questions about the implications of the decisions.

State-based marketplaces (SBMs) design their enrollment websites, control outreach and marketing, and manage the health plans offered through the marketplace. This data came from publicly available sources or directly from the marketplace.

Recent legislative committee hearings in Maryland, Florida, and Illinois provide a national snapshot of states’ diverse and innovative proposals to reign in drug costs.

This data note examines spending on insulin by Medicare and beneficiaries enrolled in private Part D drug plans, based on data from the Centers for Medicare & Medicaid Services.

Brief provides state-level data on the cost burden faced by working families who have employer-sponsored insurance (ESI) and examines how this burden varies across states, and how it has changed within states from 2010 to 2016.

These monthly briefs analyze the most recent data available on health sector employment, spending, prices, and utilization—helping to fill gaps in the official government data.

For a second time in nine months, the same federal judge has struck down the Trump administration’s plan to force some Medicaid recipients to work to maintain benefits. The ruling Wednesday by U.S. District Judge James Boasberg blocks Kentucky from implementing the work requirements and Arkansas from continuing is program.

Among other things, GAO examined: (1) Medicare and Medicaid documentation requirements and factors that contribute to improper payments due to insufficient documentation; and (2) the extent to which Medicaid reviews provide states with actionable information.

This issue brief provides the results of a literature review, aimed at pharmacy benefit managers' business practices and their consistency with public policy goals to improve the value of pharmaceutical spending.

This issue brief describes health centers’ role in health care and these two primary sources of health center revenue—Medicaid and Section 330 funding.

This article discusses the efforts of unions and their partnering employers to curb the costs of health benefits by making primary care more accessible, promoting evidence-based care, and leveraging market power to curb escalating prices for prescription drugs.

Brief estimates the state-by-state implications of full ACA repeal for insurance coverage and government funding of health care in 2019.

The report (1) describes findings on the adoption of delivery models and payment reforms related to value-based payment and alternative payment models, including progress toward achieving a preponderance of care; (2) provides an update and lessons learned on the main enabling strategies to support health care delivery transformation in quality measure alignment, health IT and data infrastructure, and practice transformation and workforce development; and (3) describes states’ efforts and challenges in improving population health.

This brief is an update of a 2017 analysis examining the characteristics of ACA marketplace rating regions with one or two participating insurers.

This report describes changes in the concentration of enrollment among issuers in (1) overall individual, small group, and large group markets, and (2) individual and small group exchanges.

Many state quality-improvement strategies for Medicaid managed care focus on primary care improvement, social determinants of health, patient engagement, and cultural competence

This report examines changes over time in the percentage of adults aged 18–64 who were prescribed medication and reported using these selected strategies to reduce their prescription drug costs in the past 12 months.

A new evaluation is under way which seeks to assess the implementation and outcomes of four different types of innovations and help CMCS shift toward data-driven decision making for future

This chart highlights multiple safeguards that seven states have enacted to create a comprehensive strategy to regulate surprise balance billing. To date, at least 22 states have introduced legislation during this session to establish or strengthen surprise balance billing protections. NASHP will continue to monitor and report on new legislative developments.

This chart compares provisions of states’ current drug affordability review board proposals.

A audio recording of a conference held on March 13, 2019

The report includes MedPAC’s analyses of payment adequacy in fee-for-service (FFS) Medicare and reviews the status of Medicare Advantage (MA) and the prescription drug benefit, Part D. Also, MedPAC recommends that the Congress replace the four current hospital quality payment programs with a single streamlined program—the hospital value incentive program (HVIP). Lastly, it reports on incentives for prescribing opioid and non-opioid pain treatment under Medicare’s hospital inpatient and outpatient payment systems.

This report addresses Medicaid hospital payment policy, a critical area of interest to Congress. Medicaid spends more on hospital services than any other type of service; these accounted for one-third of total Medicaid spending in fiscal year (FY) 2017. This year, it is focused on disproportionate share hospital (DSH) and upper payment limit (UPL) supplemental payments, making recommendations that would—if adopted—advance Medicaid’s statutory principles of efficiency, economy, quality, and access in hospital payment, as well as improve access to data that would strengthen oversight.

Brief assesses the potential financial impact on hospitals in states that have approved or pending Section 1115 demonstration waiver applications for implementing work requirements in their Medicaid programs.

This analysis, using primary research and a combination of third-party and government reports and data, quantifies the share of overall spending on retail prescription drugs retained by health plans and others in the supply and payment chain.

Brief presents both a general picture of the most frequently mentioned single-payer proposal, and delineates the advantages and disadvantages of the approach without taking a position on its advisability.

An interactive tool that illustrates the extent to which new congressional health reform bills would expand the public dimensions of the US health insurance system.

States developing accountable health models often look to Oregon for inspiration. Oregon established its Coordinated Care Organizations (CCOs) in 2012, pursuant to a Medicaid Section 1115 demonstration waiver. CCOs are local networks of all types of health care providers — including physical, behavioral, and oral health providers — that the state pays a global capitated rate to provide integrated care to Medicaid beneficiaries. This capitation model gives the CCOs flexibility to provide both health and health-related services.

With much fanfare, federal officials required hospitals nationwide this year to post their “list” prices online. But it’s not yet clear how many are doing it, even as the government has taken the rare step of asking consumers to monitor hospital compliance.

The Centers for Medicare & Medicaid Services (CMS) issued a request for information (RFI) today that solicits recommendations on how to eliminate regulatory, operational and financial barriers to enhance issuers’ ability to sell health insurance coverage across state lines.

A new issue brief looks at the impact of Medicaid on state revenue, jobs, and growth in health care wages.

States are implementing a number of strategies in Medicaid to maximize the health and well-being of children. New state policymakers will want to assess current state policy to determine if these strategies are being or should be pursued.

. Given Medicaid’s importance, new state officials will want to evaluate the program, disentangling fact from fiction, identifying challenges and opportunities, and tackling pressing program priorities. This brief highlights priority issues for consideration and potential action.

Today, managed care is the primary delivery system for Medicaid nationally, with more than 8 in 10 beneficiaries enrolled in some type of managed care across 48 states plus the District of Columbia. With this growth has come similar growth in expectations. States are covering a broader array of services for more high-need enrollees, bringing more rigor to their contracting, oversight, and payment processes, and holding managed care plans accountable for achieving targeted goals. For new state officials, this begs a critical question: Is my state getting enough value from our Medicaid managed care program?

This brief finds that affordability challenges are particularly acute for older adults with incomes just above the premium subsidy cutoff (400% of poverty), particularly in rural areas where premiums are highest.

The major mechanisms that determine out-of-pocket costs for prescription drugs are formulary tier placement and the corresponding cost-sharing. Drugs in lower tiers, like generics, usually require a modest co-pay. But in higher tiers, consumers are more likely to pay co-insurance, which exposes them to the negotiated prices of their medications.

With increased attention among policymakers towards prescription drug costs, the February 2019 KFF Health Tracking Poll finds a majority of adults, including seniors, are in favor of many policy options aimed at curbing prescription drug costs.

This report presents health insurance estimates from the first 9 months of the 2018 National Health Interview Survey

The policies highlighted in this report provide a menu of options for state leaders to explore as they consider how to best use their state’s resources to improve the health and well-being of their population.

Brief looks at how expansion efforts are faring in the Medicaid expansion ballot states as of February 2019, and what their experiences could mean for other states considering this strategy.

A new report uses transparency data (which is linked from the website) to examine claims denials and appeals among issuers offering individual market coverage on healthcare.gov from 2015-2017.

This study uses data on the actual prices allowed by several national insurers to document the pace of growth in hospital and physician prices for hospital-based care.

This brief explores the current rules for partial expansion and explains some of the potential implications for financing and coverage if CMS approves waivers to allow for partial expansion with enhanced matching funds.

Issue brief highlights some of the different approaches states have taken to adopting the Medicaid expansion initially and how those approaches may have changed over time.

A new brief examines the health care-finance connection by exploring how short-term changes in household cash flow influence consumer decisions about whether and when to seek medical care.

This policy brief discusses health insurance, demographics, health status, and access to care of undocumented low-income Californians ages 19-64.

Report dissects why surprise out-of-network billing happens and detail a suite of potential policy responses and what impacts each would have. The paper concludes with policy recommendations to eliminate surprise out-of-network billing in a manner that reduces currently inflated health care costs.

Concentration in Medicare Advantage markets between 2009 and 2017 may have been driven by consolidation in the health insurance industry generally, concentration in provider markets, and Medicare policy changes

This paper focuses on unique challenges in health insurance markets facing rural people, providers, and place by identifying how and when these challenges stem from what economists call “market failures,” defined narrowly or broadly. It reviews how previous government interventions and programs have sought to redress insurance market failures, and assesses the success (or lack thereof) of these interventions, and concludes with observations about the current landscape of rural insurance markets and suggestions for policy interventions and further research.

Advocates for Medicaid expansion promoted the idea that hospitals charge extra to patients with private insurance to make up for underpayments from the uninsured and public programs. A new report from Colorado’s Medicaid agency calls into question this theory of the “cost shift.”

This report addresses which Montanans would be affected by Medicaid work requirements, how many might lose Medicaid coverage and potential effects of provisions regarding premiums and continuous eligibility

This brief examines changes in health coverage by race and ethnicity between 2013 and 2017, providing insight into how coverage has changed since implementation of the ACA.

The annual report for 2019 looks at health care spending for individuals with employer-sponsored insurance.

Since 2006, national health expenditure (NHE) growth has been slow relative to historic growth rates. Annual spending growth between 2006 and 2017 averaged 5.2% for Medicare, 6% for Medicaid, and 4.4% for private health insurance. CMS projects much faster growth in Medicare and Medicaid spending per enrollee from 2017 to 2026 than we have seen in the past decade.These projections raise concerns about the sustainability of current trends and have been cited in proposals to dramatically restructure both programs. However, Medicare and Medicaid better contain per enrollee health spending growth than private insurance.

Brief presenst findings from the Commonwealth Fund’s latest Biennial Health Insurance Survey to assess the extent and quality of coverage for U.S. working-age adults.

Issue Brief highlights four strategies rural hospitals are using to improve value by reducing cost, improving quality or enhancing the patient experience.

In January 2018, federal officials released guidance on instituting Medicaid work requirements — an unprecedented move for the low-income health program. A year later, work requirements are pending or approved in more than a dozen states, advocates are fighting the rules in court and thousands have lost health coverage.

Tennessee is seeking federal permission to impose a work reporting requirement on low-income parents and caregivers receiving health coverage through Medicaid. Report analyses the impact the new rule would have on families with children.

Consumers shopping online for health insurance will often find websites selling short-term plans as a replacement for ACA-compliant coverage, which often fail to provide consumers with needed information.

This brief presents data from the National Health Interview Survey to examine trends in the share of nonelderly people who receive and are offered coverage through a job.

On January 30, 2019, CMS released Part II of the 2020 Advance Notice of Methodological Changes for Medicare Advantage (MA) Capitation Rates and Part D Payment Policies (the Advance Notice), and Draft Call Letter. Through the 2020 Advance Notice, CMS is proposing updates to the methodologies used to pay Medicare Advantage plans and Part D sponsors.

Brief examines the experiences of the Affordable Care Act’s marketplaces and recommend ways policymakers can harness choice and competition to improve coverage, satisfaction, and affordability.

This analysis draws on data from Medicare’s Plan Finder website to calculate expected annual 2019 out-of-pocket costs for 30 specialty tier drugs used to treat four health conditions—cancer, hepatitis C, multiple sclerosis, and rheumatoid arthritis.

This report examines (1) claims costs of issuers participating in exchanges, and (2) factors driving selected issuers' changes in exchange participation, premiums, and plan design.

This brief draws on a survey of and interviews with territory Medicaid officials, as well as other research, to examine key issues and trends in their Medicaid programs.

Report provides information on how insurance has changed under the ACA, how many people remain uninsured, who they are, and why they lack health coverage. It also summarizes what we know about the impact that a lack of insurance can have on health outcomes and personal finances and the difference health insurance can make in people’s lives.

In 2019, three hot topics will continue to demand action and timely evidence will be needed: health care spending, delivery system transformation, and persistent public health challenges.

Report summarizes interviews with marketplace administrators and insurers in ten states to look at marketplace insurer participation and pricing decisions.

A new report uses health care claims data to investigate trends in total health care spending on individuals with type 1 diabetes between 2012 and 2016. The report found that the cost of insulin has doubled in the four year period, while use of insulin remains constant.

CMS is announcing a broad array of Medicare Advantage (MA) health plan innovations that will be tested in the Value-Based Insurance Design (VBID) model for CY 2020.

This issue brief discusses potential ways to control the rising costs of health care in the United States.

This quarterly report examines current trends in U.S. health care spending, prices, utilization, and employment.

Article provides a brief history of hospitals’ role in desegregation during America’s Civil Rights era as inspiration for an integrated approach to the opioid epidemic, wherein hospitals use Medicaid expansion to advance health equity and racial healing.

On this episode of The Dose podcast, host Shanoor Seervai talks to the Commonwealth Fund’s Sara Collins about the state of the health care marketplaces. They walk you through the latest open enrollment numbers, the range of options for policymakers who want to improve access to affordable health care, and more.

This brief analyzes the CMS application processing time data and uses the 2018 Kaiser Family Foundation survey of state Medicaid and CHIP eligibility and enrollment policies to examine selected eligibility and enrollment policies by application processing time.

Brief focuses on how to build upon and improve the Medicaid Drug Rebate Program at both the federal and state levels in order to help state Medicaid programs better address their rising prescription drug costs.

At least 10 states are exploring whether to allow residents to pay premiums to “buy in” to Medicaid, the federal-state health care program for the poor.

Blog post highlights how the challenges of low population density and higher average fixed costs in rural areas can be addressed to offer affordable health insurance.

CMS has proposed changes to #Medicaid #managedcare regulations in the areas of network adequacy, beneficiary protections, quality oversight and rates and payment. 68% of Medicaid beneficiaries were enrolled in managed care organizations (MCOs) in 2016.

A new study published in Health Affairs looked at the results of mandatory bundled-payment program, Comprehensive Care for Joint Replacement.

Important Medicaid issues to watch in 2019 include Medicaid expansion developments amid ongoing litigation about the ACA’s constitutionality as well as Medicaid demonstration waiver activities, including those focused on work requirements and other eligibility restrictions.

Approximately 8.4 million people selected or were automatically re-enrolled in plans using the HealthCare.gov platform during the 2019 open enrollment period.

A new report looks at a proposed rule that would permit employers to subsidize their employees’ purchase of individual market health insurance coverage via health reimbursement arrangements (HRAs).

This brief provides an overview of current ACA-related abortion coverage policies and analyzes the potential impact of the proposed changes.

A new issue brief discusses the financial assistance provided under the ACA for people purchasing coverage on their own through health insurance Marketplaces.

On December 21, 2018, CMS issued a final rule that sets a new direction for the Medicare Shared Savings Program (Shared Savings Program). Referred to as “Pathways to Success,” this new direction for the Shared Savings Program redesigns the participation options available under the program to encourage Accountable Care Organizations (ACOs) to transition to performance based risk more quickly and, for eligible ACOs, incrementally, to increase savings for the Trust Funds.

A discussion of new regulatory guidance on the Affordable Care act

On December 14, 2018, a federal trial court judge ruled that the entire Affordable Care Act (ACA) is unconstitutional. While the trial court’s ruling is likely not the last word on the ACA’s constitutionality, this brief considers the complex and far-reaching impact were the entire law ultimately held to be invalid.

Blog post builds upon a recent report by the Georgetown University Center for Children and Families which found an increase in children’s uninsurance between 2016 and 2017. It also examines changes in uninsurance among parents during the same time period, finding that the national uninsurance rate among parents did not improve between 2016 and 2017, consistent with other data sources finding that adults’ coverage gains under the ACA appear to be stalling.

Post highlights new research on drug pricing models, the over-provision of low-value health care (LVHC) services, the impact of Medicaid expansion on mortality of end-stage renal disease patients, the impact of increased Medicaid drug spending on mortality rates, and care fragmentation and health care use.

Blog post highlights several key takeaways and insights concerning state-level Medicaid policies in 2018.

The data in this table represent Marketplace enrollment activity for the 2019 Open Enrollment Period for states using the HealthCare.gov eligibility and enrollment platform. For these states, the open enrollment period ran from November 1, 2018 through December 15, 2018.

Chart pack explores views and attitudes on the individual mandate, pre-existing conditions coverage, and state protection of pre-existing conditions.

In week seven of the 2019 Open Enrollment, 4,322,450 people selected plans using the HealthCare.gov platform or were automatically re-enrolled in a plan.

A set of practical, real-world tools to help governors and their teams address their policy priorities by improving health.

The Arkansas Department of Human Services has released monthly data related to the new requirements since June. To date, nearly 17,000 people have been disenrolled due to the new requirements. This brief looks at the data for November 2018, released on December 17, 2018.

Arkansas now requires some of its Medicaid enrollees to report monthly on their work activities to maintain their coverage. This report looks at their experiences based on focus-group discussions in urban and rural areas.

A new brief examines incremental policies that could prove the ACA, and reduce the number of uninsured by 12.2 million people.

Papers on regenerative treatments in clinical trials, novel payment models linking a drug's performance to pre-negotiated price levels, and deferred payment in a gene therapy for congestive heart failure.

This checklist identifies four issues that states may want to explore as they develop and adopt VBP models for home- and community-based services (HCBS) within managed long-term services and supports programs, including: (1) assessing available support from the state policy environment; (2) selecting the right performance measures to reward HCBS providers; (3) selecting payment models that create the right financial incentives for improved value; and (4) addressing operational issues faced by plans and providers.

The latest data on U.S. health spending are now available on the Health Spending Explorer, an interactive tool that allows users to explore trends in health expenditures by federal and local governments, insurers, service providers, and individuals. The data, which span from 1960 to 2017, are based on the just-released national health spending report from the federal government. Users can build and download custom charts, with options to filter data by type of service and source of funds.

Issue brief examines the quality of evaluation designs for demonstrations that test Medicaid eligibility and coverage restrictions.

This issue brief describes the new guidance, highlighting key changes from the 2015 guidance, describes how state waiver activity may change, particularly in light of the waiver concepts put forward by CMS, and discusses possible implications of the changes.

This analysis looks at how many of the remaining uninsured are eligible for premium subsidies large enough to cover the entire cost of a bronze plan, which is the minimum level of coverage available on the Marketplaces.

Issue brief analyzes the characteristics of people who are uninsured in Texas at both the statewide and local area level.

Issue brief describes per-beneficiary spending trends between 2007 and 2015 for post-acute care services among traditional Medicare beneficiaries age 65 and older.

To develop a more effective Medicare pay-for-performance program, policymakers should: build on experience and the literature to develop evidence-based program principles; engage clinicians to address the heterogeneity of practice structures, specialties, and conditions; emphasize broad program principles over detailed parameters in any new legislation; and plan to evaluate the program on an ongoing basis.

GAO was asked to compare IHS program characteristics, including spending levels, to those of other federal health care programs. In this report, GAO presents information on the spending levels and program characteristics for IHS, VHA, Medicare, and Medicaid from 2013 through 2017.

The public comment period for Virginia's Medicaid Section 1115 waiver for work requirements is open until January 6, 2019.

Post highlights new research on the Medicare Prospective Payment System, labor supply trends after the ACA, telemedicine benefits, and cost control incentives.

Brief uses the latest data from the federal Medical Expenditure Panel Survey–Insurance Component (MEPS–IC) to examine trends in employer premiums at the state level to see how much workers and their families are paying for their employer coverage in terms of premium contributions and deductibles.

A new report describes the influence of state and federal laws and polices on choice and competition in health care markets; and identifies actions that states or the Federal Government could take to develop a better functioning health care market.

Presentation provides an analysis of cost-sharing provisions for federal health insurance marketplace plans for 2019.

On November 20, 2018, the Centers for Medicare and Medicaid Services (CMS) re-approved a Section 1115 demonstration waiver program called Kentucky HEALTH, as a component of the state’s overall KY HEALTH (“Kentucky Helping to Engage and Achieve Long Term Health”) demonstration. Brief highlights key elements of the waiver.

This report addresses, among other objectives, (1) how CMS developed the new Medicare laboratory test payment rates; (2) challenges CMS faced in setting accurate payment rates and what factors may have mitigated these challenges; and (3) the potential effect of the new payment rates on Medicare expenditures.

This brief considers affordability as an economic concept, as a kitchen-table budget issue for individuals and families, and as a threshold in current policy. It reviews a range of measures that capture the cost burden for individuals and families with different forms of coverage, in different financial circumstances, and with different health concerns.

This brief explores state options for controlling healthcare costs and notes that policy options vary in effectiveness depending on the presence (or absence) of competition between providers, prescription drug companies and device manufacturers.

Study assesses whether patterns in individual-market participation changed following ACA implementation.

This proposed rule would amend the Medicare Advantage (MA) program (Part C) regulations and Prescription Drug Benefit program (Part D) regulations to support health and drug plans’ negotiation for lower drug prices and reduce out-of-pocket costs for Part C and D enrollees. Comments must be received by January 25, 2019.

For the first time in nearly a decade, the number of uninsured children in the United States increased. Recently released data shows an estimated 276,000 more children were uninsured in 2017 than in 2016. No state (except for the District of Columbia) experienced a significant decline in the number of uninsured children in 2017.

This data note explores sources of supplemental coverage among beneficiaries in traditional Medicare, based on data from the 2016 Medicare Current Beneficiary Survey (the most recent year available).

This report provides average effectuated enrollment and premium data for the Federal and State-Based Exchanges for the first six months of the 2018 plan year.

Report describes significant vulnerabilities observed in the Medicare wage index system.

In some health insurance markets, increased competition may result in a reduction in the purchasing power of subsidized consumers by narrowing the gap between the benchmark premium and plans that are cheaper than the benchmark.

This issue brief assesses the state reinsurance programs’ progress in accomplishing their goals and outlines the lessons they have learned so far.

The newest KFF tracking poll focuses on the public's priorities for the next Congress, immigration and health care, health care costs, the future of the ACA and Medicaid expansion, ACA open enrollment, prescription drug advertisements, pre-existing coverage, and women's health.

Post breaks down the proposed Marketplace Integrity rule and its implications for state marketplaces, insurance departments, and the consumers they serve.

Report estimates the effects of the proposed DHS public charge rule relating to legal immigrants on health center revenue, staffing, and patient care capacity.

A new report projects significant losses in health insurance coverage in California when the ACA individual mandate is eliminated in 2019.

This Policy Brief is the second report from the Rural and Underserved Health Research Center assessing rural/urban disparities in pneumococcal vaccine service delivery among the fee-for-service (FFS) Medicare population. This report is an update of the initial report and was conducted to specifically assess uptake of the 13-valent pneumococcal conjugate vaccine (PCV13) following revised vaccination recommendations released in 2014.

Using the California Simulation of Insurance Markets (CalSIM) microsimulation model and a range of assumptions about the extent to which the penalty influences enrollment decisions, study projects that between 150,000 and 450,000 more Californians will be uninsured in 2020, growing to between 490,000 and 790,000 more uninsured in 2023, compared to the projected number if the ACA penalty had been maintained.

Brief analyzed premium data from insurer rate filings to state regulators and healthcare.gov to see how premiums are changing at the county level both before and after subsidies in 2019.

This brief highlights key regulatory changes to the Merit-based Incentive Payment System (MIPS) in 2018 and discusses the importance of the changes, particularly as they affect small and rural practices.

A new brief examines the concept of affordability as an economic concept for families and individuals, and as a threshold for policymakers.

This brief looks at the Medicaid-disenrollment data for October 2018, released on November 15, 2018.

A new publication looks at the impact of health utilization and health care spending for groups with high costs and high healthcare/social needs.

In this report, GAO examined (1) states' oversight practices, and (2) CMS's actions for helping to ensure encounter data reliability. GAO reviewed documents on oversight practices, and interviewed Medicaid officials from eight states, selected based on enrollment and geography; and collected information from two MCOs (one with low and one with high enrollment) in each of the eight states.

This report describes quality of health care received in 2017 by Medicare beneficiaries nationwide. Specifically, the report highlights rural-urban differences in health care experiences and clinical care and looks at how these differences vary by race and ethnicity.

Analysis of federal data shows insurance plans in urban areas had significantly lower premiums than plans in rural areas for the most commonly purchased coverage under the Affordable Care Act.

The latest in HSR topics includes premiums for employer-sponsored healthcare, costs and quality of markets for physician services, and managed care and continuity of coverage,.

Brief Identifies factors that explain differences in issuers’ participation levels in state insurance marketplaces.

A new report looks at the limitation of short term health insurance plans, which cover the insured for under 12 months and often lack consumer protections.

A new report looks at health insurance costs under the ACA relative to urban and rural areas.

Insurer participation in the ACA health insurance marketplaces is rising in 2019.

In week two of the 2019 Open Enrollment, 804,556 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday.

his collection provides updated information about Medicare Advantage enrollment trends, premiums, and out-of-pocket limits. It also includes new analyses of Medicare Advantage plans’ extra benefits, use of prior authorization, and bonus payments paid by Medicare.

This study examined changes in coverage for adult obesity treatment services in Medicaid and state employee health insurance programs between 2009 and 2017.

Proceedings from a June 2018 workshop on the economic and programmatic transitions that are changing the global health landscape.

This proposed rule advances CMS’ efforts to streamline the Medicaid and Children’s Health Insurance Plan (CHIP) managed care regulatory framework and reflects a broader strategy to relieve regulatory burdens; support state flexibility and local leadership; and promote transparency, flexibility, and innovation in the delivery of care. These proposed revisions of the Medicaid and CHIP managed care regulations are intended to ensure that the regulatory framework is efficient and feasible for states to implement in a cost-effective manner and ensure that states can implement and operate Medicaid and CHIP managed care programs without undue administrative burdens.

By bundling services and encouraging interprofessional and inter-organizational collaboration, integrated health care models counter fragmented health care delivery and rising system costs. Building on a policy impetus toward integration, the Ministry of Health and Long-Term Care in the Canadian province of Ontario chose 6 programs, each comprising multiple hospital and community partners, to implement bundled care, also referred to as integrated funding models. This article explores the generation of integration through the dynamic interplay of contexts and mechanisms and of structures and subjects.

Brief assesses whether health insurance coverage gains from 2010 to 2016 were associated with changes in labor market outcomes across occupations.

A collection of interactive graphics providing data on uninsured rates for people under age 65 in completely rural counties, counties that are mostly rural, and counties that are mostly urban. Includes state and county-level data.

This fact sheet highlights key states in which the results of the 2018 midterm elections have implications for Medicaid expansion adoption or implementation.

In week one of Open Enrollment for 2019, 371,676 people selected plans using the HealthCare.gov platform. As in past years, enrollment weeks are measured Sunday through Saturday. Consequently, week one was only three days long this year - from Thursday to Saturday.

Study estimates the impact of the Kentucky work requirements on rates of uninsured and hospital finances, especially for safety-net hospitals.

Study assesses whether state Medicaid work requirement projects are designed for success in promoting employment among unemployed Medicaid beneficiaries.

The latest in health policy research is focused on state-level individual mandates, state-level financing for Hep C treatment and prevention, carrier participation in the ACA, and hospital price variations.

Using data combined from the 2013-2015 National Health Interview Surveys, this brief examines characteristics of individuals with Medicaid coverage - children and adults - in rural areas, as well as their access to care and use of services, comparing their experience to their privately insured and uninsured counterparts.

This final rule with comment period revises the Medicare hospital outpatient prospective payment system (OPPS) and the Medicare ambulatory surgical center (ASC) payment system for CY 2019 to implement changes arising from our continuing experience with these systems.

CMS just finalized significant changes to the Home Health Prospective Payment System to strengthen and modernize Medicare. Specifically, CMS made changes to improve access to solutions via remote patient monitoring technology, updated payments for home health care with a new case-mix system, begin the new home infusion therapy benefit, and reduce burden.

Brief considers health care affordability as an economic concept, as a kitchen-table budget issue for individuals and families, and as a threshold in current policy.

Brief estimates the effect that excluding coverage of preexisting conditions would have on patients’ out-of-pocket expenses.

On November 1, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a final rule that includes updates to payment policies, payment rates, and quality provisions for services furnished under the Medicare Physician Fee Schedule (PFS) on or after January 1, 2019.

HHS is requesting information on: how plans and providers serving Medicare beneficiaries identify beneficiaries with social risk factors; approaches plans and providers have used to address the needs of beneficiaries with social risk factors; evidence regarding the impact of these approaches on quality outcomes and the total cost of care; and ways in which plans and providers disentangle beneficiaries’ social and medical risks and address each. Comments will be open until November 16, 2018.

Paper analyzes those who would be impacted by an expansion of work requirements in SNAP and an introduction of work requirements into Medicaid.

HHS answers questions about the International Price Index Model, a proposed way of paying for physician-administered drugs within Medicare.

Analysis quantifies the effects of the eligibility rules and more limited benefits generally found in short-term plans on the premiums in those plans.

A new report examines how alternative payment models have affected physician practices.

This guide is an overview of the Medicare Advantage (MA) star ratings for calendar year 2019. The Centers for Medicare & Medicaid Services (CMS) publishes the star ratings each year to help beneficiaries find the best plan for them and to determine MA quality bonus payments to plans. States can use the ratings to help assess the plans operating in their state, especially Dual Eligible Special Needs Plans (D-SNPs) with which they may have contracts to provide services to Medicaid beneficiaries.

This page aggregates tracking information on pending and approved Section 1115 Medicaid waivers.

This report provides an in-depth examination of the changes taking place in Medicaid programs across the country, highlighting certain policies in place in state Medicaid programs in FY 2018 and policy changes implemented or planned for FY 2019.

This fact sheet identifies features of short-term policies consumers may wish to check carefully.

Using the latest data from our annual Employer Health Benefits Survey (EHBS), study assessed access to employer sponsored health insurance (ESI) coverage for same sex spouses in 2018, as well as trends over time; ESI remains the primary way people in the U.S. receive health coverage, either directly or as a spouse or other dependent.

This proposed rule would revise the Medicare Advantage (MA) program (Part C) regulations and Prescription Drug Benefit program (Part D) regulations to implement certain provisions of the Bipartisan Budget Act of 2018; improve quality and accessibility; clarify certain program integrity policies; reduce burden on providers, MA plans, and Part D sponsors through providing additional policy clarification; and implement other technical changes regarding quality improvement.

On October 26, 2018, the Centers for Medicare & Medicaid Services (CMS) issued a proposed rule that updates Medicare Advantage (MA or Part C) and the Medicare prescription drug benefit program (Part D) by promoting flexibility and innovation so that MA and Part D sponsors are empowered with the tools to improve quality of care and provide more plan choices for MA and Part D enrollees.

With the effective repeal of the individual mandate penalty and the expansion of short term and association health plans, researchers set out to quantify how much of an upward effect these policy and legislative changes are having on 2019 premiums.

Study works to understand how the ACA’s market reforms have affected prices, enrollment, and competition in the small-group market.

On Thursday, CMS announced and sought input on a new “International Pricing Index” (IPI) payment model to reduce what Americans pay for prescription drugs. Under the IPI model, described in an Advance Notice of Proposed Rulemaking (ANPRM), Medicare’s payments for select physician-administered drugs would shift to a level more closely aligned with prices in other countries. Overall savings for American taxpayers and patients are projected to total $17.2 billion over five years.

This brief analyzes Medicaid enrollment and spending trends for FY 2018 and FY 2019 based on interviews and data provided by state Medicaid directors as part of the 18th annual survey of Medicaid directors in all 50 states and the District of Columbia.

Study examines the relationship between patients’ perceptions of equity-oriented health care and selected patient-reported health outcomes by testing a theoretical model informed by current theory and evidence.

Recently there has been increased interest in how U.S. drug prices compare to those of other developed countries. Much of this interest focuses on pricing for pharmacy-dispensed drugs, which account for about 72 percent of total prescription drug spending. This paper focuses on prices for non-retail drugs, which are generally physician-administered.

Brief outlines Medicaid provisions in the SUPPORT for Patients and Communities Act, a wide-ranging bill seeking to address the opioid crisis. The bill contains numerous provisions that affect how state Medicaid agencies structure and administer services and supports for individuals with opioid and other substance use disorders (SUD).

New guidance has been announced by CMS that gives states a real measure of flexibility to innovate better ways to provide Americans with more affordable, higher quality health care.

States would be able to use federal funding to provide subsidies to people buying short-term health insurance policies, which typically don’t provide comprehensive coverage, under guidance released Monday by the Trump administration. The new policy could begin taking effect in 2020. It would allow states to ask for waivers from Affordable Care Act provisions governing not only subsidies that help pay for premiums, but also the benefits insurers must include in plans offered on the federal marketplace to consumers buying their own coverage.

Brief uses data from the federal Medical Expenditure Panel Survey (MEPS) to look at the coverage patterns of Medicaid beneficiaries and then use this information to project the potential impact in Kentucky of work requirements on insurance coverage.

This survey looks at the results of the costs of serious illness on patients and families.

The Essential Scan, produced by the USC-Brookings Schaeffer Initiative for Health Policy, aims to help keep you informed on the latest research and what it means for policymakers. This week's topics include the 340B prescription drug pricing program, work requirements for Medicaid, Medicaid and the opioid epidemic, and financing of safety-net hospitals.

A new report looks at 19 state managed care organization to determine if CMS 2016 rules represent a major departure from current state practice or simply reflected current approaches to networks and access standards,

This report describes 2016 national survey estimates of (1) the number and demographic characteristics for low-income adults who were uninsured in expansion and non-expansion states, (2) unmet medical needs for low-income adults in expansion and non-expansion states and by insurance status, (3) barriers to health care for low-income adults in expansion and non-expansion states and by insurance status, and (4) having a usual place of care and receiving selected health care services for low-income adults in expansion and non-expansion states and by insurance status.

This fact sheet provides an overview of the Medicare Part D program, plan availability, enrollment, and spending and financing, based on data from the Centers for Medicare & Medicaid Services (CMS), CBO, and other sources.

Fact sheet outlines the basics of accountable care organizations.

Using 2014 Survey of Income and Program Participation data, it examines the (1) share of noncitizens who originally entered the U.S. without legal permanent resident status who have characteristics that DHS could potentially weigh negatively in a public charge determination and (2) number of individuals who would disenroll from Medicaid under different scenarios.

Since 2010, enrollment in Medicare Advantage has doubled to more than 20 million enrollees, growing from a quarter of Medicare beneficiaries to more than a third.

Centers for Medicare & Medicaid Services (CMS) recently announced that the average premium for second lowest cost silver plans (SLCSP) for the 2019 coverage year will drop by 1.5 percent, the first time average premiums have dropped since the implementation of the Federally- facilitated Exchange in 2014.

This report examines the role of long-term services and supports (LTSS) in Medicaid. It also examines how sociodemographic changes are likely to affect the demand for LTSS in the future, and as a result, Medicaid use and expenditures.

The purpose of this State Health Official (SHO) letter is to describe some key provisions of the HEALTHY KIDS and ACCESS Acts that are related to CHIP as well as other children’s coverage and quality provisions.

On October 12, 2018, the Centers for Medicare & Medicaid Services (CMS) released the 2019 premiums, deductibles, and coinsurance amounts for the Medicare Part A and Part B programs.

Regional Accountable Entities, or RAEs, are new organizations in Health First Colorado, Colorado’s Medicaid program. They are responsible for coordinating members’ care, ensuring they are connecting with primary and behavioral health care, and developing regional strategies to serve Health First Colorado members

Table indicates the average monthly premiums for the second-lowest cost silver plan (SLCSP) and lowest cost plan (LCP) across all 39 states using the using the HealthCare.gov platform, as well as state-level average SLCSP and LCP premiums.

Brief summarizes cost-effective alternative proposals to the Medicare-for-All plan proposed by Senator Sanders.

This brief summarizes key features of recent health policy proposals introduced in Congress, highlights similarities and differences, and discusses key questions, trade-offs and potential implications.

CMS recently announced that 1,299 entities have signed agreements with the agency to participate in the Administration’s Bundled Payments for Care Improvement – Advanced (BPCI Advanced) Model. The participating entities will receive bundled payments for certain episodes of care as an alternative to fee-for-service payments that reward only the volume of care delivered.

This study uses extensive claims data from three large private insurers to provide a national picture of private-sector spending and pricing variation and to delve into the reasons for this variation.

Brief outlines the provisions of the Substance Use Disorder Prevention that Promotes Opioid Recovery and Treatment for Patients and Communities (SUPPORT) Act which will impact Medicaid.

This brief analyzes the early experience with implementation of work and reporting requirements in Arkansas, based on publicly available data and information, as well as targeted interviews with state officials, health plans, providers, and beneficiary advocates conducted in August and September 2018.

Brief reviews how bundled payments have changed the cost and quality of care, as well as whether they have had any unintended impact on access and equity.

Brie fused financial data reported by insurance companies to the National Association of Insurance Commissioners and compiled by Mark Farrah Associates to look at the average premiums, claims, medical loss ratios, gross margins, and enrollee utilization from second quarter 2011 through second quarter 2018 in the individual insurance market.

Report provides recommendations for pediatric-to-adult transition value-based payment (VBP) strategies and quality measures.

With workers harder to find and Obamacare’s tax on generous coverage postponed, employers are hitting pause on a feature of job-based medical insurance much hated by employees: the high-deductible health plan.

The threat to consumers posed by bills from out-of-network (OON) health care providers is an issue that has been gaining prominence lately, with coverage from the media and growing policymaker interest. A number of states have addressed the problem legislatively, and others are considering taking action.

This brief aims to identify the major design challenges involved in changing Medicare eligibility and outline alternative strategies and considerations involved in navigating each.

This policy brief uses data from the California Health Interview Survey and the California State Controller to discuss the effect of Medi-Cal enrollment on county health department spending in California.

Charts demonstrate the benefits of Medicaid expansion, including improved health coverage, access to health care, health outcomes, financial security, employment support, substance use treatment, and financial health for rural hospitals.

The 2018 survey provides a detailed look at trends in employer-sponsored health coverage including premiums, employee contributions, cost-sharing provisions, offer rates, wellness programs, and employer practices.

Held on September 25, 2018, slides and additional resources from the teleconference are available for viewing.

Brief examines the Affordable Care Act’s impact on small businesses, solo entrepreneurs, and small-business employees.

Report describes (1) decisions that influenced the structure of Medicaid HCBS programs, and (2) challenges providing HCBS to Medicaid beneficiaries and efforts to respond to these challenges.

Chart collection focuses on recent trends in spending on prescription drugs among people with employer coverage, with a particular focus on people with high drug spending and high out-of-pocket drug spending.

An updated collection of state Medicaid fact sheets from the Kaiser Family Foundation summarizes Medicaid coverage and spending nationally and in each state. The fact sheets for each state are accessible via an interactive map of the U.S. and display a wide range of data.

This paper examines the status of insurance coverage for low-income citizen adults in the 46 states with significant rural populations.

Brief examines patterns of un-insurance and Medicaid/CHIP participation among children and parents through 2016, the third full year following implementation of the major ACA coverage provisions.

Issue brief highlights midterm ballot initiatives and state and federal elections that could impact Medicaid.

On September 18, a bipartisan group of six Senators released draft legislation to protect patients in both insured and self-insured plans from surprise out-of-network bills. Titled the “Protecting Patients from Surprise Medical Bills Act,” the draft legislation represents only the second near-comprehensive Congressional bill to address the issue (Representative Michelle Lujan Grisham’s “Fair Billing Act of 2017” being the other).

This brief explores changes in health insurance coverage from 2016 to 2017 by state using newly available estimates from the American Community Survey.

This report describes the experience of Tennessee and Virginia, who used their certificates of public advantage (COPA) laws to approve a large health system merger that spanned their state borders.

Oklahoma's Medicaid agency just signed its second value-based contract for a prescription drug used to treat serious bacterial skin infections.

On orders from Congress, Medicare is easing up on its annual readmission penalties on hundreds of hospitals serving the most low-income residents, records released last week show.

This briefing book includes data and strategies the next Ohio governor and General Assembly can use to develop evidence-informed policies that will improve the health of all Ohioans.

Post provides the latest health policy research on accountable care organizations, financial incentives for quality of care, MIPS, and reducing unnecessary hospital admissions and readmissions through value-based initiatives.

A bipartisan group of senators Tuesday unveiled a plan to protect patients from surprise bills and high charges from hospitals or doctors who are not in their insurance networks.

This guide describes considerations for states seeking to adopt value-based payment models for home- and community-based services in Medicaid managed long-term services and supports (MLTSS) programs.

Report explores the challenges to rural insurance markets, which are often not accounted for in the way insurance markets are structured, and considers recommendations to better support the use of managed care in rural areas.

Issue brief examines evidence on health care coverage and access among low-income Kansans and to review the potential impact of expanding Medicaid with the possible addition of a work requirement as a condition of eligibility.

With the goal of enhancing access and affordability for people vulnerable due to low incomes and poor health, this issue brief proposes a policy that would reduce Medicare’s cost-sharing and premiums for beneficiaries with incomes below 150 percent of the federal poverty level.

This report presents statistics on health insurance coverage in the United States in 2017, changes in health insurance coverage rates between 2016 and 2017, as well as changes in health insurance coverage rates between 2013 and 2017.

Analyzing federal data, authors report the number of uninsured Americans fell from 17.0 percent in 2013 to 10.0 percent in 2016—driven by coverage gains spurred by the Affordable Care Act (ACA). The number of people with health insurance coverage rose by 18.5 million during the period.

Brief describes how reference pricing can be and has been applied to drugs in the United States and compares it to more conventional pharmaceutical benefit designs such as tiered formularies and coinsurance.

This brief examines changes in health insurance coverage and health care access and affordability for parents and their children between 2013 and 2018 using data from the Health Reform Monitoring Survey.

In a Commonwealth Fund–supported study in Health Affairs, researchers explored the effect of market consolidation across California between 2010 and 2016 on outpatient visit prices and premiums for individual coverage on the Covered California marketplace.

Report examines how CMS assures that (1) state-reported Medicaid expenditures are supported and consistent with requirements; and (2) the correct federal matching rates were applied to expenditures subject to a higher match.

Chart collection compiles KFF’s most relevant polling on single-payer healthcare, national health plans, and expanding Medicare, including how differences in framing language and arguments affects people’s views and the priority voters say they place on the issue heading into this year’s midterm election.

An issue brief discusses U.S. attitudes towards possible elimination of protections for individuals with pre-existing medical conditions.

In this cohort study, difference-in-differences analysis of more than 3 million non-Medicare hospitalizations from the inpatient databases of 30 states found that ACA expansion states had a significant reduction in the proportion of uninsured hospitalizations for major cardiovascular events within 1 year of Affordable Care Act Medicaid expansion compared with nonexpansion states.

This report presents health insurance estimates from the first quarter of the 2018 National Health Interview Survey

GAO was asked to examine outreach and enrollment for the exchanges using healthcare.gov. This report addresses (1) 2018 open enrollment outcomes and any factors that may have affected these outcomes, (2) HHS's outreach efforts for 2018, and (3) HHS's 2018 enrollment goals.

A letter to state Medicaid Directors that explains how to calculate budget neutrality expenditure limits for Medicaid section 1115 demonstration projects.

Brief examines data released by the Arkansas Department of Human related to Medicaid work requirements in June and July.

This paper describes the approaches used by Colorado and Washington to increase administrative efficiencies and reduce barriers for consumers seeking to apply for and renew enrollment in their state Medicaid programs.

CMS just awarded $8.6 million in funding to 30 states and the District of Columbia to provide State insurance regulators with the opportunity to enhance States' ability to strengthen their respective health insurance markets through innovative measures that support market reforms and consumer protections under the Patient Protection and Affordable Care Act (PPACA).

This data note presents trends on the Part D coverage gap and discusses recent and proposed changes affecting out-of-pocket costs for Part D enrollees who reach the coverage gap.

Under the Affordable Care Act, states can pursue "innovation waivers,"(1332 waivers), which allow modification of key parts of the law, so long as they stay true to its goals and consumer protections

Chartbook uses data from the Medical Expenditure Panel Survey-Insurance Component (MEPS-IC) to highlight the experiences of private-sector workers with employer-sponsored insurance (ESI) from 2013 through 2017 at the national level and in the states.

The survey offers a big-picture look at Americans’ health insurance, including the quality of their coverage.

The Accountable Health Communities Model is an interactive website, based on emerging evidence that addressing health-related social needs through enhanced clinical-community linkages can improve health outcomes and reduce costs.

Toolkit that can be used to help prepare a state Medicaid plan amendment to request reimbursement for preventive services provided by health education specialists.

This excel table contains the most up to date state-level data available related to certain provisions of the Affordable Care Act. This table includes data on the uninsured, private market reforms, employer coverage, Medicaid, the individual market (including the Health Insurance Marketplace), and Medicare.

A publicly available source of data providing researchers, payers, regulators, and innovators with metrics quantifying the temporal and regional patterns of health care spending and utilization, particularly with regard to the diffusion and exnovation of medical interventions. Website allows the public to download complete datasets of selected variables spanning decades; newer data will be posted as they become available.

Resources to help publicize the C2C initiative, aimed at connecting individuals with health coverage and to primary care and the preventive services.

Raw data and overviews on the design, affordability, and cost-sharing features of plans offered in ACA health insurance marketplaces across all 50 states.

This report presents statistics on health insurance coverage in the United States in 2014, and on changes in coverage between 2013 and 2014.

This report presents statistics on health insurance coverage in the United States based on information collected in the 2014, 2015, 2016, 2017, and 2018 Current Population Survey Annual Social and Economic Supplements (CPS ASEC) and the American Community Survey (ACS).

The US Census Bureau's collection of health insurance statistical information.

To support more consistent monitoring and rigorous evaluation of section 1115 demonstrations, CMS partnered with Mathematica to design monitoring and evaluation tools and guidance to support these activities. These resources Include implementation plan templates, monitoring report templates, and evaluation design guidance.

Website is designed to help states improve the quality and cost-effectiveness of care for individuals who are dually eligible for Medicare and Medicaid and includes a resource library, interactive map of state integration activities, and an events calendar.

A continually updated repository of statistics on Medicaid and CHIP enrollment and spending, and documents with key aspects of both programs.

A tool designed to help state Medicaid agencies design and launch accountable care organizations.

Tool designed to provide pricing within ambulatory surgical centers and hospital outpatient departments of various procedures. Look up by textword or by code.

The Commonwealth Fund conducts survey of health care consumers, health professionals, and health system leaders. Site allows users to explore our data, analyses, and methods.

Interactive map allows users to learn more about what actions that state is taking which may affect access to adequate coverage.

Use this site to access all of CMS' materials and educational opportunities that will help users better understand and educate others about Medicare, Medicaid, the Children's Health Insurance Program (CHIP), and the Federally-facilitated Health Insurance Marketplace.

Provides easy to understand defintions of health economic terms.

Report summarizes health plan selections made on the individual Exchanges during the 2019 Open Enrollment Period (2019 OEP) for the 39 states that use the HealthCare.gov eligibility and enrollment platform, as well as for the 12 State-Based Exchanges (SBEs) that use their own eligibility and enrollment platforms.

A searchable glossary of health insurance-related terms.

Report focuses on the process that the Congressional Budget Office and The Joint Committee on Taxation use to analyze proposals affecting health insurance coverage for people under age 65, such as legislation that would make major changes to the Affordable Care Act (ACA).

This 17th annual survey of the 50 states and the District of Columbia (DC) provides data on Medicaid and the Children’s Health Insurance Program (CHIP) eligibility, enrollment, renewal, and cost sharing policies as of January 2019.

Comprehensive report on the impact of the Affordable Care Act and health care system reform.

CBO uses the Health Insurance Simulation Model to estimate the cost of various health care proposals, including the expansion of public programs, mandates for people to have insurance, and insurance market reforms.