Medicare Beneficiaries

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.

Expanding access to high-quality, affordable health care has been a priority of the Biden-Harris Administration.

This research report updates prior reports on Medicare FFS telehealth trends during the COVID-19 public health emergency with data through end of 2021, by beneficiary characteristics, visit specialty and geography including by state. Medicare telehealth flexibilities during the COVID-19 pandemic continued to encourage use of telehealth among Medicare beneficiaries in 2021.