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  • Explaining Health Care Reform: How Might a Reform Plan Be Financed?

    Issue Brief

    One of the key challenges in enacting a health care reform plan is how to finance it among government, employers, and individuals. Of particular concern to policymakers is what effect a health reform plan would have on government spending and the federal budget. President Obama and Congressional leaders have said that any health reform plan should not add to the budget deficit over a 10 year period. This brief explains the likely sources of added…

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

    Issue Brief

    New: Medicare Advantage Plan Star Ratings and Bonus Payments in 2012 In 2012, Medicare Advantage plans will be awarded additional payments based on their quality ratings as a result of the 2010 health reform law. The Centers for Medicare and Medicaid Services has proposed a demonstration that would modify the quality-based payments for plans, providing additional payments for 2012 to 2014. This policy brief by the Kaiser Family Foundation examines the quality ratings of private…

  • The Distributional Consequences of  Medicare Premium Support Proposal

    Other Post

    The Distributional Consequences of a Medicare Premium Support Proposal This article analyzes the expected distributional impact of enacting a premium support proposal for Medicare based on legislation introduced by Sen. Breaux and Sen. Frist in 1999. This legislation suggested that the Federal Employees Health Benefits plan be used as a model for Medicare. The article simulates impacts in three areas: among beneficiaries who choose to retain fee-for-service coverage, between different geographic areas, and according to…

  • Medicare Chartbook, 2010

    Report

    This chartbook provides the most recent and reliable data available about the Medicare program and the 47 million seniors and younger people with disabilities who get health insurance coverage through the program. Topics covered include: Medicare beneficiaries; the program's benefits, utilization, and access to care; prescription drugs; the Medicare Advantage program; the role of Medicaid for Medicare beneficiaries; supplemental insurance coverage; out-of-pocket spending; and Medicare spending and financing. Printable Chartbook (.pdf)

  • Program Integrity: Preventing Health Care Fraud and Abuse

    Event Date:
    Event

    Headlines regularly call attention to pockets of fraudulent activity in the health care arena - scams that amount to millions and potentially billions of dollars. The stories typically focus on catching the crooks but not so much on efforts to prevent fraud, waste and abuse in health care programs. Both types of efforts are important. With continued concerns about rising health care costs and the current focus on deficit reduction, how much money can be…

  • Medicare Payments and Beneficiary Costs for Prescription Drug Coverage

    Issue Brief

    This March 2007 issue brief, commissioned by the Kaiser Family Foundation, provides a basic introduction to the reimbursement system for private Medicare drug plans. It explains the system of plan bidding and payment, including the special provisions for low-income enrollees, and considers how aspects of the payment system may affect the total cost of the drug benefit over time, the cost of coverage for beneficiaries and the variety and quality of available plans. Mark Merlis…

  • Explaining Health Care Reform: How Do Health Care Costs Vary By Region?

    Issue Brief

    Although regional variations in health spending have been studied for decades, there is renewed focus on this issue because of the role of health care costs in health care reform and the potential source of funds if addressing cost variations can yield savings. This explainer examines what is known about regional variations in health care costs and their relationship to quality of care, and addresses key questions about their role in health reform. Issue Brief…

  • Medicare Part D Update: Lessons Learned and Unfinished Business

    Report

    Enacted in 2003, Medicare’s Part D prescription drug benefit reflected an unprecedented and controversial new approach for Medicare, relying exclusively on private plans to provide health coverage and including an unusual gap in coverage. This analysis by Kaiser researchers examines in detail how the new model has worked since its launch almost four years ago. Published as an article in today’s New England Journal of Medicine, the analysis by Kaiser vice president Patricia Neuman and…

  • Medicare Part D 2010 Data Spotlight: Coverage of Top Brand-Name and Specialty Drugs

    Issue Brief

    This Part D Data Spotlight documents the wide variations across the private stand-alone drug plans with respect to coverage of drugs, what enrollees pay for those drugs, and restrictions and limitations placed on their use. These variations have potentially significant implications for beneficiaries’ access to medications and out-of-pocket costs. The spotlight is one in a series analyzing key aspects of the Medicare Part D drug plans that will be available to beneficiaries in 2010. The…