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This brief presents key facts and analysis about affordability of health care costs among people with Medicare, including younger adults with long-term disabilities, drawing on data from various sources.
Note: This publication is no longer in circulation. However, a few copies may still exist in the Foundation's internal library that could be xeroxed. Please email order@kff.org if you would like to pursue this option.
This study examines Medicaid pharmacy benefit use and spending among beneficiaries dually eligible for Medicare and Medicaid in 10 states by analyzing 1995 enrollment and claims data from a new 12-state database. The study finds that dual-eligibles are relatively high users of the Medicaid pharmacy benefit, with substantial variation in both drug use and spending among this population across the 10 study states. This variation appears to persist independent of beneficiaries' health status and is…
Despite continued tight state budgets, a requirement in the Affordable Care Act (ACA) that states maintain eligibility in Medicaid and Children’s Health Insurance Programs was central in preserving coverage during 2011. In addition, more than half of states (29) made improvements in their programs, often using technology to increase program efficiency and streamline enrollment. These and other findings appear in the Kaiser Commission on Medicaid and the Uninsured report, "Performing Under Pressure: Annual Findings of…
Medicaid coverage substantially improves access to health care and lessens the financial burden of medical care for low-income seniors, but the program currently reaches only half of all poor Medicare beneficiaries. This report presents findings of focus groups with low-income seniors in an effort to understand barriers to enrollment for those who are eligible for Medicaid but who are not enrolled in the program, and to learn about the experiences of low-income seniors who are…
Understanding the Health-Care Needs and Experiences of People with Disabilities: Findings from a 2003 Survey People with disabilities are at risk in the health-care system because of their wide-ranging health-care needs, their relatively heavy use of prescription drugs, health-care and support services, and typically low incomes. A new survey of people with permanent mental and/or physical disabilities explores their health-care experiences and challenges in accessing and paying for care. Report (.pdf) Chartpack, video, press release,…
This comprehensive survey of people on Medicare, conducted in June and July 2004, assesses their attitudes toward the new Medicare drug law. This chartpack, issued in September 2004, presents additional analysis on the survey data, focusing on the views of people under age 65 with physical and/or mental disabilities. Supplemental Chartpack (.pdf)
On September 21, 2023, the Centers for Medicare and Medicaid Services (CMS) finalized a rule that is intended to help low-income Medicare beneficiaries gain access to Medicaid coverage of Medicare premiums and often, cost sharing, through the Medicare Savings Programs.
Chip talks with Dr. Toyin Ajayi, co-founder and CEO of Cityblock Health, which delivers value-based care to more than 100,000 Medicaid and dual-eligible members across ten states, many of them people of color managing chronic conditions. Ajayi makes a pointed case: Roughly 60 percent of health care AI investment goes to billing, coding, and risk adjustment — making sure someone gets paid — while only a fraction goes to delivering care. If we continue to…
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)
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