Medicare Program Integrity and Efforts to Root Out Improper Payments, Fraud, Waste and Abuse
This brief explains fraud, waste, abuse, and improper payments in Medicare and describes actions to ensure Medicare program integrity.
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This brief explains fraud, waste, abuse, and improper payments in Medicare and describes actions to ensure Medicare program integrity.
Virtually all (98.9%) of the 2.6 million Medicare beneficiaries enrolled in a Medicare Advantage plan that terminated coverage at the end of 2025 have at least one MA-PD available in 2026, including more than two-thirds (68.7%) who have the option of enrolling in a plan sponsored by the same insurer.
This brief about the 2018 Medicare Part D marketplace analyzes the latest data on Medicare drug coverage and trends over time, including both stand-alone prescription drug plans and Medicare Advantage drug plans. The analysis focuses on enrollment, premiums, cost sharing, and the low-income subsidy.
In 2018, three Medicare Part D plan sponsors—UnitedHealth, Humana, and CVS Health—account for more than half of the program’s 43 million Part D enrollees (55%) and two-thirds of all stand-alone drug plan enrollees, indicating a marketplace that is dominated by a handful of major insurers, according to a new Kaiser Family Foundation analysis of Part…
Gretchen Jacobson, Associate Director of the Foundation's Program on Medicare Policy, testified on June 7, 2017 before the U.S. House Committee on Ways and Means, Subcommittee on Health. Her testimony focused on three approaches for integrating and coordinating care for Medicare beneficiaries, and the opportunities and challenges presented by these approaches.
This data spotlight report examines trends in the Medicare Advantage marketplace, including the choices available to Medicare beneficiaries in 2014, premium levels and other plan features. Medicare beneficiaries, on average, will have 18 private Medicare Advantage plans available to them in 2014, reflecting both new plans entering the market and old plans exiting it. If Medicare Advantage enrollees remain in their current plans, average monthly premiums will rise by almost $5 per month, or 14 percent, to $39 per month. The analysis also examines some benefits provided by Medicare Advantage plans including drug coverage and caps on out-of-pocket spending, and finds that average out-of-pocket limits across all plans will climb 11 percent to $4,797 in 2014. Additionally, this analysis examines changes in the types of plans available (HMOs, PPOs, etc.), including special needs plans in 2014.
Now Available: 2012 Medicare Advantage Spotlight: Plan Availability and Premiums The Kaiser Family Foundation has issued a series of data spotlights and issue briefs examining the Medicare Advantage plan options available in 2011 and trends affecting the Medicare Advantage marketplace.
Three key private health insurance markets -- Medicare Advantage, the individual market and the fully-insured group market -- appear to be financially healthy and attractive to insurers. The private Medicare Advantage market generates significantly larger gross margins per person than the individual market or fully-insured market. The future of these markets has become a focus for policymakers amid the debate over Medicare for All.
This Data Spotlight reviews national and state-level enrollment trends as of March 2015 and examines variation in enrollment by plan type and firm. It analyzes the most recent data on premiums, out-of-pocket limits, Part D cost-sharing for drugs, and plans’ quality ratings for Medicare Advantage enrollees.
This data spotlight examines changes in the availability and premiums of private Medicare Advantage options for Medicare beneficiaries in 2010 as the annual open enrollment period begins. While the number of plans available in 2010 declined somewhat from 2009, the analysis finds that Medicare beneficiaries on average have 33 Medicare Advantage plans to choose from.
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