Healthcare Financing & Expenditures

The U.S. Department of Health and Human Services (HHS), Office of the Assistant Secretary for Planning and Evaluation (ASPE) released new research on spending and utilization trends of Medicare Part B drugs, drugs administered in physicians' office or hospital outpatient departments rather than being purchased at the pharmacy counter or by mail order.

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%.

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.

This Brief presents information about the risk of needing care and associated costs to provide content for policymakers and others considering long-term care financing proposals. It revises a brief that was written in October 2020.

This brief introduces the HHS Roadmap for Behavioral Health Integration, which advances the President’s Strategy to Address our National Mental Health Crisis. It provides a general overview of the approach HHS is taking to drive toward integrated care within the three pillars of the President’s Strategy and highlights selected programs and policy actions that will get us there.

Key Findings Policy discussion surrounding U.S. prescription drug prices focuses on whether prices in the United States are too high or appropriate relative to the benefits that they offer to patients.

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 implementati

Medicare served nearly 63 million beneficiaries in 2019. 62 percent were enrolled in Part A or Part B, and the rest (37 percent) were in Medicare Advantage (Part C). 74 percent were enrolled in Part D drug coverage, 13 percent had private drug coverage, and nearly 9 percent had no drug coverage. Demographic characteristics and health status varied across these groups.

President Biden’s Executive Order 14036, “Promoting Competition in the American Economy” (the Competition Executive Order), identifies a lack of competition as a key driver for problems across economic sectors.

This report responds to a requirement in Executive Order 13877, "Improving Price and Quality Transparency in American Healthcare to Put Patients First." It describes the phenomenon of a "surprise billing," particularly in the commercial insurance market, the underlying federal and state regulatory frameworks, and recent state actions to address the problem.