Research & Analysis

On average, in 2022, Medicare Advantage enrollees had plans that covered only 48% of the physicians that traditional Medicare beneficiaries could access, according to an Oct. 27 KFF report. The study reviewed 4,200 individual HMO/PPO MA plans that covered 20.3…

Coverage for drugs recently approved by the FDA can take months to solidify, according to the Institute for Clinical and Economic Review’s “Launch Price and Access Report,” published Oct. 23. Researchers reviewed 24 drugs from Boston-based Tufts Medical Center’s specialty…

The high cost of GLP-1 drugs have thrown a curveball at payer strategy. Employers providing health insurance are also grappling with the fallout. From January to July, Davis Research interviewed business owners and human resource and benefits managers at 1,862…

In 2025, the average annual premium for family health insurance reached $26,993, according to KFF’s employer health benefits survey. From January to July, Davis Research interviewed business owners and human resource and benefits managers at 1,862 firms for the survey.…

Commercial insurance prices were 78% higher in hospital outpatient settings compared with ambulatory surgical centers in 2024, according to a Health Affairs study published in October. The analysis, led by researchers at Brown University, examined 2024 pricing data for UnitedHealthcare,…

Short-term, limited-duration health plans — also known as “junk” plans — are options for those facing a temporary gap in health coverage, like when someone is between jobs. In August, the Trump administration said it would not enforce Biden-era regulations…

Premiums for employer-provided coverage could increase by about 5% to 14% for employers that cover GLP-1s, according to an Oct. 9 analysis from the Employee Benefit Research Institute. With 55% of employers covering GLP-1s for diabetes and 36% for both…

Insurers that own providers can use internal transactions to inflate medical spending figures and reduce their rebate obligations under the ACA’s medical loss ratio rules, according to an analysis published Sept. 29 in Health Affairs. The analysis was published by…

Seventy-eight percent of U.S. adults want Congress to extend the enhanced ACA tax credits, according to a KFF poll published Oct. 3.  While the vast majority of Democrats and independents support an extension, most Republicans and “Make America Great Again”…

Commercially insured patients pay substantially different rates for the same procedure, with negotiated costs for inpatient procedures varying by an average ratio of 9.1, according to an August report from market intelligence firm Trilliant Health. The report reviewed health plan…