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  • The “Clawback:” State Financing of Medicare Drug Coverage

    Issue Brief

    This issue paper describes the origins of the clawback, the formula by which each state’s clawback amount is calculated, and the clawback’s implications for states and for low-income Medicare beneficiaries. Issue Paper (.pdf)

  • Insights on Transitioning From Medicaid to the New Medicare Prescription Drug Benefit

    Report

    The Kaiser Commission on Medicaid and the Uninsured convened a focus group of state Medicaid officials in November 2005 to discuss the impact of the new Medicare drug program on states and Medicaid enrollees. State insights on the transition of dual eligibles and some beneficiary experiences are discussed in new material and an audio briefing. Podcast: December 19, 2005 Conference Call Briefing (Downloadable Audio File) Presentations from the December 19, 2005 Conference Call Briefing (.pdf)…

  • Kaiser Health Poll Report Survey – Selected Findings on Seniors’ Views of the Medicare Prescription Drug Benefit

    Poll Finding

    Kaiser Health Poll Report Survey – Selected Findings on Seniors' Views of the Medicare Prescription Drug Benefit This February 2006 Kaiser Family Foundation tracking poll finds that 45% of seniors say they have enrolled or plan to enroll in a drug plan, 29% say they do not intend to enroll in a drug plan and another 23% say they are uncertain. The majority of those who do not plan to enroll say they have another…

  • Medicaid’s Long-Term Care Users: Spending Patterns Across Institutional and Community-based Settings

    Issue Brief

    The nation's primary payer for long-term services and supports, Medicaid finances 43 percent of all spending on long-term care services and covers a range of services and supports, including those needed by people to live independently in the community, as well as services provided in institutions. This report provides an overview of long-term care users and their acute and long-term care service spending. The report finds that although the individuals who rely on long-term care…

  • Quick Take: Geographic Variation in Dual Eligible Enrollment

    Fact Sheet

    Over 9 million elderly Americans and younger persons with disabilities are jointly enrolled in the Medicaid and Medicare programs.  These “dual eligibles” receive coverage for most medical services from Medicare, and they also receive Medicaid assistance for Medicare premiums and cost-sharing and coverage of benefits not offered under Medicare (such as long-term care).  Dual eligibles are among the sickest and poorest individuals covered by Medicare and Medicaid and, as a group, account for a disproportionate…

  • The New Medicare Drug Benefit:  Potential Effects of Pharmacy Management Tools on Access to Medications

    Issue Brief

    The New Medicare Drug Benefit: Potential Effects of Pharmacy Management Tools on Access to Medications This report describes the pharmacy benefit management tools that will be available to private plans administering the new Medicare drug benefit, including formularies, the definition of categories and classes, and cost sharing requirements. The authors conclude that substantial flexibility given to plans to design management tools could have significant implications for beneficiaries’ access to needed medications and out-of-pocket spending. Issue…

  • Grievance and Appeals Procedures: An Analysis of the MMA and Proposed Regulations

    Issue Brief

    This paper, by Sara Rosenbaum, J.D., Director of the Center for Health Services Research and Policy at George Washington University, examines the procedures for resolving beneficiaries' grievances and appeals under the new Medicare drug benefit. It is one in a series commissioned by the Kaiser Family Foundation that analyzes issues surrounding the implementation of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the proposed regulations. Issue Brief (.pdf)

  • Navigating Medicare and Medicaid: A Resource Guide for People with Disabilities, Their Families, and Their Advocates

    Report

    Navigating Medicare and Medicaid: Resource Guides for People with Disabilities, Their Families, and Their Advocates These guides explain the critical role Medicare and Medicaid have come to play in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities - and give people with disabilities new information to help them get the most from these programs. Navigating Medicare and Medicaid, 2005 Keeping Medicare and Medicaid When You Work, 2005