Prescription Drugs

Actuarial Value and Employer-Sponsored Insurance. Data and Methods

The actuarial values were derived by running a claims payment program against a standard population. NCS data on provisions such as covered services (e.g., inpatient hospital, outpatient hospital, physician visits, mental health, and prescription drugs) and cost-sharing parameters (copayments, deductibles, coinsurance, out-of-pocket maximums, an

Variation and Trends in Medigap Premiums. Trends in Medigap Premiums

Average Medigap premiums rose from $127 in 2001 to $177 in 2010, an average annual increase of approximately 3.8 percent. As displayed on Figure 10, annual growth rates were higher early in this decade then in more recent years. As a point of comparison, the average annual change in Medicare spending per beneficiary (without Part D spending) was 5

Variation and Trends in Medigap Premiums. Background

While Medicare covers many services, it does not cover them in full. Individuals with Medicare coverage are responsible for some out‐of‐pocket expenses such as copayments, coinsurance, and deductibles (see Appendix A for more information). Fee‐for‐service Medicare also does not include a cap on out‐of‐pocket payments. Medigap (also cal

The Affordable Care Act and Women. Improved Medicare Coverage

Women represent 56.9 percent of Americans aged 65 years and over, almost all of whom participate in Medicare. 8 The 24.7 million women who have coverage through Medicare can now receive additional preventive services without cost-sharing, including an annual wellness visit, a personalized prevention plan, mammograms, and bone mass measurement f

Historical and Projected Trends in Medicaid. VII. Projections of Enrollment and Spending ¹³

a. Enrollment Trends and Projections Enrollment growth in the Medicaid program will play a large part in determining future spending. According to figures presented by OACT in the President’s FY 2007 Budget, Medicaid enrollment is expected to increase from 47.2 million enrollees in 2004 to 58.6 million in 2016, a 24 percent increase (see Fig

Historical and Projected Trends in Medicaid. V. Current Medicaid Data

a. Federal/State Spending Medicaid expenditures continue to rise along with health care spending in general. The total expenditures for Medicaid by both federal and state sources were $298 billion in 2004. This represents 2.5 percent of the nation’s Gross Domestic Product (GDP) and 15.9 percent of the nation’s total health spending of $1.9

Historical and Projected Trends in Medicaid. III. Background

Medicaid is a program that pays for medical assistance for certain individuals and families with low incomes and resources. The program became law in 1965 and is jointly funded by the Federal and state governments (including the District of Columbia and the Territories) to assist states in providing medical acute and long-term care assistance to p

CHIPRA Mandated Evaluation of the Children's Health Insurance Program: Final Findings. Table B.5. Parents’ Reported Access, Use, and Care Experiences of Children in Medicaid Compared to the Uninsured and those with Private Insurance

Percentage of Medicaid Enrollees, Pooled 3- State a Percentage Point Difference Between Medicaid Enrollees and Children Who b Were Uninsured Percentage Point Difference Between Medicaid Enrollees and Children Who Were Privately Insured c Access to Care Based on Parent’s Reports

CHIPRA Mandated Evaluation of the Children's Health Insurance Program: Final Findings. Table B.4. Access and Use Among CHIP and Medicaid Enrollees in Three States (California, Florida, and Texas), 2012

Reports for the Past 12 months CHIP Enrollees Medicaid Enrollees Access to Care Based on Parent Reports Had USC or Private Doctor or Nurse During Past 12 Months 87 85 USC Type: Private Doctor's Office or Group Practice/HMO 44

CHIPRA Mandated Evaluation of the Children's Health Insurance Program: Final Findings. Impacts of CHIP and Medicaid on Access, Use, Content of Care and Family Well-Being 55

Ultimately, the impact of CHIP and Medicaid on the lives of children and their families depends on the extent to which the program improves access to care, receipt of services, and satisfaction with care, and reduces the financial burden of care for the children who enroll. To measure the impact of CHIP on the health and well-being of children and

CHIPRA Mandated Evaluation of the Children's Health Insurance Program: Final Findings. Access, Service Use and Care Experiences of CHIP and Medicaid Enrollees ⁵¹

CHIP provided high levels of access to care, but areas for program improvement remain.

CHIPRA Mandated Evaluation of the Children's Health Insurance Program: Final Findings. Finding 6 (Chapter VIII)

Finding 6 (Chapter VIII): Compared to being uninsured, children in Medicaid and CHIP experienced better access to care, fewer unmet needs, and greater financial protection. Compared to having private insurance, CHIP enrollees had better access to dental benefits and their families had much lower financial burdens and stress in meeting the child�

Estimated Savings of $5,000 to Each Medicare Beneficiary from Enactment Through 2022 Under the Affordable Care Act. Methods

This memo was prepared by analysts in the Office of the Assistant Secretary for Planning and Evaluation (ASPE) in consultation with the Office of the Actuary (OACT) of the Centers for Medicare & Medicaid Services (CMS).

Estimated Savings of $5,000 to Each Medicare Beneficiary from Enactment Through 2022 Under the Affordable Care Act. Summary

The Affordable Care Act, enacted in 2010, makes many changes to strengthen Medicare and provide better benefits to seniors, while slowing cost growth. As a result, average Medicare beneficiary savings in traditional Medicare will be approximately $5,000 over the 2010 to 2022 period (see Table 1). Beneficiaries who have high prescription drug spend

Estimated Savings of $5,000 to Each Medicare Beneficiary from Enactment Through 2022 Under the Affordable Care Act

This report provides estimates of Medicare Parts A, B, and D savings from the Affordable Care Act to seniors and people living with disabilities enrolled in traditional Medicare. The Affordable Care Act will favorably affect beneficiary expenditures in four ways: lowering part B premiums growth, lowering beneficiary copayments and coinsurance grow

ib.pdf
PDF

Diabetes: A National Plan for Action. Treatment

The availability of high-quality diabetes care services is crucial to support persons with diabetes in their efforts to manage the disease and prevent complications. Agencies within HHS support a variety of programs intended to measure and inform the quality of diabetes care in the United States.

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities. State Data

Long, Marquis, and Rogers (1995) present insight based on conversations with staff from states on priorities for health expenditure data, including why such information is used, what the concepts and components of health expenditure accounts are, and what issues and priorities exist in enhancing information. The issues include the scope of health

Using Behavioral Economics to Inform the Integration of Human Services and Health Programs under the Affordable Care Act . Research findings

This report does not analyze how Marketplaces and Medicaid programs can best structure the application and health plan choice process. Rather, we focus on that process’s cognitive demands to understand the consumer’s mindset when faced with the additional questions posed by possible SNAP enrollment.

Information Needs Associated with the Changing Organization and Delivery of Health Care: Summary of Perceptions, Activities, Key Gaps, and Priorities

This report summarizes the insights and conclusions drawn from a project to asses unmet needs for supply-side information on the health system. The project focused on identifying how information needs associated with a changing health care system are perceived by providers, insurers, purchasers, consumers, and government at various levels. The proj

infoneed.pdf
PDF

Performance Improvement 2009. Appendix E - Studies by Agency

Studies by Agency Elements of evaluation: Effective programs achieve results. Results derive from good management which requires good decisions. Good decision-making depends on good information. Good information requires good data and careful analysis. Creative project officers, skillful researchers, thoughtful an

Content by Keyword: Prescription Drugs