Medicare

New & Noteworthy
Examining the Potential Impact of Medicare’s New WISeR Model

A federal initiative to establish new prior authorization requirements in traditional Medicare, called the Wasteful and Inappropriate Service Reduction (WISeR) model, is likely to have only modest impact in its first year.

State Profiles for Dual-Eligible Individuals

This data collection draws on Medicare and Medicaid administrative data to present national and state-level information on people who are covered by both Medicare and Medicaid, referred to as dual-eligible individuals (also known as dually-enrolled beneficiaries).

Data Visualization

The Facts About Medicare Spending

This interactive provides the facts on Medicare spending. Medicare, which serves 67 million people and accounts for 12 percent of the federal budget and 21 percent of national health spending, is often the focus of discussions about health expenditures, health care affordability and the sustainability of federal health programs.

Explore data on enrollment growth, Medicare spending trends overall and per person, growth in Medicare spending relative to private insurance, spending on benefits and Medicare Advantage, Part A trust fund solvency challenges, and growth in out-of-pocket spending by beneficiaries.

Related: FAQs on Medicare Financing and Trust Fund Solvency

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  • Medicare Advantage Plans in 2017: Short-term Outlook is Stable

    Issue Brief

    This issue brief analyzes the number and variety of Medicare Advantage plan choices available to beneficiaries in 2017. It describes trends in number of Medicare Advantage plans and plan quality ratings, and new information on plan premiums, out-of-pocket expense limits, and other plan features. This spotlight is part of a series of spotlights tracking key changes in the Medicare Advantage program.

  • What Might a Repeal of the Affordable Care Act Mean for Medicare?

    News Release

    As Republican policymakers consider how to repeal and replace the Affordable Care Act (ACA), they are likely to face a number of decisions about whether to retain any of the law’s changes to Medicare. Repealing the ACA has potential implications for Medicare spending, beneficiaries, and other stakeholders, according to a new Kaiser Family Foundation brief.

  • Poll: Family Members of Older Adults with Serious Illness Are More Confident That They Know Their Medical Wishes When They Have Written Documents

    News Release

    Most Seriously Ill Seniors Struggle with Cognitive and Mental Health Challenges; Nearly Half Reportedly Have Problems Understanding Drug and Medical Instructions Seniors with serious illness and their families are more likely to feel their wishes for medical care are being followed when they have written them down, finds a new Kaiser Family Foundation survey on…

  • “What is CMMI?” and 11 other FAQs about the CMS Innovation Center

    Fact Sheet

    The Center for Medicare and Medicaid Innovation (CMMI), also known as the "Innovation Center," was authorized under the Affordable Care Act with the goals of designing, implementing, and testing new payment and delivery system reform models to address concerns about rising costs, quality of care, and inefficient spending. These FAQs provide an overview of the Innovation Center, as well as details on model performance, beneficiary involvement, and more.

  • Summary of Recent and Proposed Changes to Medicare Prescription Drug Coverage and Reimbursement

    Issue Brief

    On February 9, 2018 the President signed into law the Bipartisan Budget Act of 2018, which included some provisions related to Medicare Part D prescription drug coverage. Shortly thereafter, the Office of Management and Budget released the President’s fiscal year (FY) 2019 budget, which also included several proposals related to Medicare Part D drug coverage and Part B drug reimbursement. This brief summarizes these recently enacted and proposed changes.

  • Insulin Costs and Coverage in Medicare Part D

    Issue Brief

    In light of heightened attention to insulin and the Trump Administration’s new Part D model to address out-of-pocket costs for insulin for Medicare beneficiaries, we analyzed out-of-pocket spending on insulin by beneficiaries enrolled in Part D drug plans, variation in Part D plan formulary coverage and tier placement of insulin products, and trends in prices for insulin.