In 2024, federal spending on Medicare Advantage bonus payments will total at least $11.8 billion, as nearly three-quarters of enrollees are in a plan that received bonus payments. The average bonus payment is higher for employer plans and lowest for special needs plans, raising questions about the implication of the quality bonus program for equity.

This analysis examines who was eligible for Medicare and/or Medicaid between 2002 and 2022 because they received disability benefits from one of the country's Social Security disability programs, Social Security Disability Insurance (SSDI) or Supplemental Security Income (SSI.) Many who receive SSDI and SSI qualify for both Medicare and Medicaid, known as dual-eligible individuals.

The Centers for Medicare & Medicaid Services (CMS) recently concluded the first round of negotiation for the new Medicare Drug Price Negotiation Program, which was established by the Inflation Reduction Act. These FAQs address several questions related to Medicare’s drug price negotiation program and CMS's implementation of the new program, with a focus on the details that apply for 2026, the first year that negotiated prices will be available under this new program.

This post for Health Affairs Forefront examines how the results of the first-ever Medicare drug price negotiations will generate savings for the government and for Medicare beneficiaries, and how candidates' views on the issue could play a role in the upcoming elections and in the future of government negotiation.

Medicare Advantage plans denied 3.4 million prior authorization requests for health care services in whole or in part in 2022, or 7.4% of the 46.2 million requests submitted on behalf of enrollees that year, according to a new KFF analysis of federal data. That was a higher share of denials than in recent years. The…More