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The Henry J. Kaiser Family Foundation

Modifying Medicare’s Benefit Design: What’s the Impact on Beneficiaries and Spending?

This report examines an approach to reforming Medicare that has been a focus of Congressional hearings and featured in several broader debt reduction and entitlement reform proposals, and was included in the June 2016 House Republican health plan. The analysis models four different options for modifying Medicare’s benefit design, all of which include a single deductible, modified cost-sharing requirements, a new cost-sharing limit, and a prohibition on first-dollar Medigap coverage. The analysis models the expected effects on out-of-pocket spending by beneficiaries in traditional Medicare, and assesses how each option is expected to affect spending by the federal government, state Medicaid programs, employers, and other payers, assuming full implementation in 2018.

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The Henry J. Kaiser Family Foundation

Modifying Traditional Medicare’s Benefit Design Could Reduce Federal Spending But With Cost Tradeoffs Between Beneficiaries and The Federal Government

Revamping traditional Medicare’s benefit design and restricting “first-dollar” supplemental coverage could reduce federal spending, simplify cost sharing, protect against high medical costs, decrease out-of-pocket spending for many beneficiaries, and provide more help to those with low incomes — but would be unlikely to achieve all of these goals simultaneously.

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The Henry J. Kaiser Family Foundation

Medicare Advantage 2016 Data Spotlight: Overview of Plan Changes

This issue brief analyzes the number and variety of Medicare Advantage plan choices available to beneficiaries in 2016. It describes trends in number of Medicare Advantage plans, plan premiums, and plan quality ratings, including changes in prescription drug coverage and limits on out-of-pocket expenses. This spotlight is part of a series of spotlights tracking key changes in the Medicare Advantage program.

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The Henry J. Kaiser Family Foundation

It Pays to Shop: Variation in Out-of-Pocket Costs for Medicare Part D Enrollees in 2016

This analysis focuses on out-of-pocket drug costs for Medicare Part D enrollees in 2016 for specialty, brand, and generic drugs. Part D drug plans differ considerably in the drugs they list on their formularies, their use of formulary tiers, and the level and structure of cost sharing applied to those tiers. Plan decisions affect different beneficiaries in different ways, depending on the drugs they use. The financial consequences for Part D plan enrollees can be substantial. In addition to examining costs for common drugs, we also examine profiles of multiple drugs for several hypothetical Part D enrollees.

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The Henry J. Kaiser Family Foundation

10 Essential Facts About Medicare and Prescription Drug Spending

Prescription drugs play an important role in medical care for 57 million seniors and people with disabilities, and account for $1 out of every $6 in Medicare spending. This series of charts presents and explains basic facts about prescription drug spending specifically within the context of Medicare. These 10 charts include information on current and projected Medicare prescription drug spending, out-of-pocket prescription drug costs for beneficiaries, the effects of the closing Part D “doughnut hole” and introduction of costly specialty drugs on beneficiary costs, and public opinion on prescription drug-related policy options.

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The Henry J. Kaiser Family Foundation

Medicare Spending at the End of Life: A Snapshot of Beneficiaries Who Died in 2014 and the Cost of Their Care

This data note provides a snapshot of Medicare beneficiaries who died in 2014 and their Medicare spending at the end of life. It examines Medicare per capita spending trends over time since 2000 and in 2014, both overall and by type of service, for beneficiaries in traditional Medicare who died in a given year compared to those who survived the year.

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The Henry J. Kaiser Family Foundation

A Study of Medicare Advantage Plan Networks in 20 Counties Finds That Plans Include About Half of All Hospitals in Their Area 

A Kaiser Family Foundation analysis of private Medicare plan networks finds that Medicare Advantage plans include about  half of area hospitals in their network, on average, while one in five plans have no  Academic Medical Center in-network.  Among plans in an area with a National Cancer Institute-designated cancer center, more…

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The Henry J. Kaiser Family Foundation

Will House Republican Health Proposal and Trustees’ Report Make Medicare a Factor in Election?

In this Wall Street Journal Think Tank column, Drew Altman discusses Medicare having a low profile this campaign season, and whether the House Republican health reform plan and Medicare trustees’ report this week will push it more into the spotlight as an issue.

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The Henry J. Kaiser Family Foundation

Medicare Advantage Plan Switching: Exception or Norm?

The Medicare open enrollment period allows enrollees to compare plans, stick with their current plan, switch to another plan, or shift to traditional Medicare. This analysis examines the extent to which Medicare Advantage enrollees change plans when given the opportunity. It also analyzes the variation in the rate of plan switching by enrollee and plan characteristics and whether people who voluntarily switch plans tend to move to plans with lower premiums, lower out-of-pocket limits, or higher quality ratings.

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The Henry J. Kaiser Family Foundation Headquarters: 2400 Sand Hill Road, Menlo Park, CA 94025 | Phone 650-854-9400
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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.