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  • The Part D Experience: What are the Lessons for Broader Medicare Reform?

    Event Date:
    Event

    Launched in 2006, Medicare added a prescription drug benefit that relies entirely on private plans, while, for other benefits, beneficiaries have a choice between private health plans and traditional fee-for-service Medicare. As policymakers consider changes to Medicare that would give an even greater role to private health plans in caring for Medicare’s nearly 50 million seniors and people with disabilities, the Kaiser Family Foundation hosted a policy workshop to examine how the Part D experience…

  • Cost and Access Challenges: A Comparison of Experiences Between Uninsured and Privately Insured Adults Aged 55 to 64 with Seniors on Medicare

    Report

    This analysis looks at the difficulties uninsured people ages 55-64 have accessing and affording health care in 2010. Four in 10 of these near-seniors report having unmet health care needs or delaying treatment, while three in 10 uninsured near-seniors lived in families reporting problems paying their medical bills largely due to the cost. Seniors on Medicare report problems accessing care at a significantly lower rate than uninsured near-seniors and at a similar rate to near-seniors…

  • Prescription Drug Procurement and the Federal Budget

    Issue Brief

    This brief commissioned by the Foundation considers areas where Medicare faces limited opportunity for market-based competition and price negotiation to drive down drug spending. These areas include drug purchasing for low-income people enrolled in Part D plans who face minimal cost-sharing requirements, and purchasing certain unique drugs, such as biologicals, that have no therapeutic alternatives or competitors. Authored by Richard G. Frank of Harvard University, the brief discusses policy options that could lower Medicare spending…

  • Medicare Part D Spending Trends: Understanding Key Drivers and the Role of Competition

    Issue Brief

    This brief commissioned by the Foundation examines factors that contributed to Medicare's lower-than-expected spending on prescription drugs under the Medicare Part D drug benefit that started in 2006. Since its launch, Medicare has spent about 30 percent less on Part D benefits than the Congressional Budget Office originally projected. Some cite the program's design, with private plans competing for enrollment, as the driving factor in lower spending; others point to factors in the overall market…

  • How Does the Benefit Value of Medicare Compare to the Benefit Value of Typical Large Employer Plans?: A 2012 Update

    Issue Brief

    This study compares the value of Medicare's fee-for-service benefits last year with the value of benefits in two large employer health plans -- a large health plan serving federal employees and a typical large employer Preferred Provider Organization (PPO) plan. For individuals ages 65 and older, the study finds that Medicare remains less generous on average than typical large employer health plans, even after recent improvements in the program's drug coverage. Overall, Medicare would cover…

  • Medicare’s Role for Dual Eligible Beneficiaries

    Issue Brief

    About 9 million low-income seniors and younger people with disabilities in the United States are covered by both Medicare and Medicaid. This brief examines the role of Medicare in providing health coverage for these beneficiaries. Medicare is the primary source of health insurance, while Medicaid provides supplemental coverage, helping with premiums and cost-sharing and paying for services not covered by Medicare. This brief examines overall and per capita Medicare spending for these beneficiaries, including variations…

  • Key Issues in Understanding the Economic and Health Security of Current and Future Generations of Seniors

    Issue Brief

    As part of broad deficit-reduction plans, policymakers are considering reforms to the nation's three major entitlement programs - Medicare, Medicaid and Social Security - that could significantly affect the economic security of seniors in their retirement years. This brief examines the role of these programs in ensuring seniors' financial security as well as the challenges facing current and future generations when it comes to economic and health security. Drawing from current research and data, the…

  • Talking About Medicare: Your Guide to Understanding the Program, 2012

    Report

    Medicare is the federal health insurance program for people 65 and older and for some younger adults with permanent disabilities and medical conditions.  Prior to 1965, the year in which the Medicare program was established, about half of all seniors lacked health insurance.  Today, virtually all people 65 and older have coverage under Medicare, and are eligible for this coverage without regard to their income or medical history.  Medicare currently provides health insurance coverage for…

  • The Ups and Downs of Medicare Part B Premiums: Frequently Asked Questions

    Issue Brief

    This brief examines how Medicare Part B premiums for many beneficiaries are affected by the annual cost-of-living adjustment (COLA) for Social Security benefits. Based on the most recent projections from the Medicare and Social Security Trustees, the brief examines the interactions between the two programs that resulted in some Medicare beneficiaries paying significantly higher Part B premiums in 2010 and 2011 when there was no Social Security COLA, followed by a drop in premiums in…

  • Medicare Advantage 2012 Spotlight: Plan Availability and Premiums

    Report

    This brief highlights trends in the Medicare Advantage marketplace, including the choices available to Medicare beneficiaries in 2012, premium levels and other plan characteristics. The brief was authored by researchers at Mathematica Policy Research and the Kaiser Family Foundation. Data Spotlight (.pdf)