Medicare Beneficiaries

This issue brief summarizes analyses of Medicare fee-for-service data examining beneficiary use of tele-behavioral health services during 2019 and 2020. Results demonstrate that the number of Medicare beneficiaries receiving behavioral health care via telehealth increased dramatically during the COVID-19 public health emergency.

This Issue Brief explores telehealth use for people and Medicare beneficiaries with disabilities and examines questions on the use of audio-only telehealth during the second and third years of the coronavirus disease 2019 (COVID-19) pandemic.

Effective January 1, 2023, the Inflation Reduction Act (IRA) eliminated cost sharing and deductibles for adult vaccines recommended by the Advisory Committee on Immunization Practices (ACIP) covered under Medicare Part D. In 2023, 10.3 million Medicare Part D enrollees received a recommended vaccine free of charge, which saved enrollees more than $400 million in out-of-pocket costs.

This issue brief uses Medicare fee-for-service data to conduct illustrative analyses of primary care spending using a methodology that has been frequently used by policymakers and academics and can be applied to claims data.

In 2022, 43.3 million Medicare Part D enrollees (82 percent) filled 1.1 billion prescriptions for generic prescription drugs. While most enrollees filled at least one prescription for $2 or less, most (54 percent) paid more than $2 for at least one generic drug. Over 6 million enrollees filled at least one prescription for over $20.

The Inflation Reduction Act’s (IRA) expanded financial assistance in Medicare’s Low-Income Subsidy (LIS) Program would have benefited nearly 461,000 Partial LIS enrollees had the provision been in effect in 2020. An additional 2.9 million Part D enrollees who were eligible but not enrolled in LIS would also have benefited from the program.

Stakeholders, researchers, and policymakers have identified varying nursing home ownership structures and ownership transactions as potentially influencing the quality of care delivered to vulnerable residents.

This report describes validation of claims-based frailty algorithms for potential use in Medicare claims. Related Products:

RAND identified use cases on identifying frailty using electronic health record (EHR) data in health systems in the US and examples from other countries, which demonstrate applications in both primary and specialist care. The final EHR implementation guide summarizes the learnings from participants in the EHR Learning Network and the identified use cases.

The Inflation Reduction Act (IRA) authorizes the Secretary of the Department of Health and Human Services (HHS) to negotiate prices directly with participating manufacturers for selected drugs that are high expenditure, single source drugs without generic or biosimilar competition.