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When Costs Are a Barrier to Getting Health Care: Reports from Older Adults in the United States and Other High-Income Countries: Findings from the 2021 International Health Policy Survey of Older Adults

October 1, 2021

Issue: Unlike older adults in other high-income countries, those in the United States face significant financial barriers to getting health care, despite Medicare's universal coverage. These barriers may affect use of health services as well as health outcomes.Goal: To compare the out-of-pocket spending and care-seeking experiences of older Americans with those of older adults in 10 other high-income countries.Methods: Analysis of findings from the Commonwealth Fund's 2021 International Health Policy Survey of Older Adults.Key Findings: One-fifth of older Americans spent more than $2,000 out of pocket on health care in the past year. Only a small share of older adults in most of the other surveyed countries had such high out-of-pocket health costs. Similarly, a higher share of older Americans reported forgoing health care because of costs. Rates of skipping dental care because of costs were similar for older adults in nations that do not offer coverage of such services, including the U.S.Conclusions: Older Americans pay more for health care and are more likely to not get care for cost-related reasons than people in other high-income countries. Affordability remains a concern and should continue to be a focus of research and policy.

Achieving the Right Balance: Privacy and Security Policies to Support Electronic Health Information Exchange

June 4, 2012

Outlines the importance of a statewide health information exchange system to ensure efficient information flows, as well as the role of robust privacy and security policies in maintaining the public trust. Proposes a framework of nine principles.

Medicare Advantage Plan Star Ratings and Bonus Payments in 2012

November 21, 2011

Estimates total Medicare spending on and distribution of quality ratings-based bonus payments for Medicare Advantage plans in 2012 by company, tax status, state and county and in relation to cuts in plan payments under federal health reform.

The Budget Control Act of 2011: Implications for Medicare

September 1, 2011

Outlines how the timeline for and process of lowering the federal deficit in exchange for raising the debt ceiling could affect Medicare spending through sequestration, including cuts in payments to Medicare Advantage plans, Part D, and providers.

Reaching for the Stars: Quality Ratings of Medicare Advantage Plans, 2011

February 17, 2011

Outlines the Centers for Medicare and Medicaid Services' quality ratings of Medicare Advantage plans, including locations and types of highly rated plans, and a proposed demonstration to modify the quality-based payments authorized by the reform law.

Medicare Spending and Use of Medical Services for Beneficiaries in Nursing Homes and Other Long-Term Care Facilities

October 12, 2010

Analyzes Medicare spending on and utilization by beneficiaries in long-term care facilities for hospitalizations, emergency room visits, and skilled nursing facilities. Explores ways to reduce hospitalizations, save costs, and improve the quality of care.

To Hospitalize or Not to Hospitalize? Medical Care for Long-Term Care Facility Residents

October 12, 2010

Examines factors behind frequent hospitalizations of long-term care facility residents, such as limited capacity, physician preferences, and financial incentives. Suggestions include support and training, advanced care planning, and changes in thinking.

Quality Ratings of Medicare Advantage Plans: Key Changes in the Health Reform Law and 2010 Enrollment Data

September 9, 2010

Examines performance measures used to set plans' quality ratings, 2010 healthcare reform provisions for bonus payments to plans with high ratings, plan enrollment by rating, and ratings by plan type, analyzed by state and county. Considers implications.

Medicare Advantage 2010 Data Spotlight: Plan Enrollment Patterns and Trends

June 22, 2010

Provides data on nationwide enrollment trends in Medicare Advantage plans by plan type, area, region, and firm or affiliate. Also examines trends in enrollment in group and special needs plans, market concentration, and premiums.

Health Insurance Coverage for Older Adults: Implications of a Medicare Buy-In (Dec 2009)

December 14, 2009

Examines the health insurance status of adults ages 55 to 64, characteristics of the uninsured, their health status, and barriers to affordable coverage. Reviews key features of past Medicare buy-in proposals and their implications for improving coverage.

Health Insurance Coverage for Older Adults: Implications of a Medicare Buy-In (May 2009)

May 13, 2009

Examines the health and insurance status of 55- to 64-year-olds, characteristics of the uninsured, and barriers to affordable coverage. Outlines elements of Medicare buy-in proposals, including eligibility, premiums, and subsidies, and their implications.