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  • The Rising Cost of Living Longer: Analysis of Medicare Spending by Age for Beneficiaries in Traditional Medicare

    Report

    This analysis provides a detailed look at per person Medicare spending on the nearly 30 million beneficiaries over age 65 who are enrolled in the traditional Medicare program. Among the key findings of the report is that per person spending rises with age, peaking at age 96. But this rise is not entirely explained by Medicare spending on end of life care, which declines with age. What Medicare spends money on also changes as beneficiaries…

  • The ACA Primary Care Increase: State Plans for SFY 2015

    Perspective

    This perspective provides additional information on state plans related to the Affordable Care Act's (ACA) primary care rate increase after the 100% federal financing ends December 31, 2014. The data in this report were collected as part of KCMU’s Annual Medicaid Budget Survey, conducted by Health Management Associates with the support of the National Association of Medicaid Directors,

  • Paying a Visit to the Doctor: Current Financial Protections for Medicare Patients When Receiving Physician Services

    News Release

    As the Congress continues to work on reforming Medicare payments for physician services, a new Kaiser Family Foundation brief examines key provisions in current law that help provide safeguards and financial protections for beneficiaries when they visit their doctor, and explains how potential changes could affect beneficiaries, providers, and the Medicare program. These provisions include: The participating provider program encourages physicians and other practitioners to charge no more than Medicare fees for services provided to…

  • Medicare Patients’ Access to Physicians: A Synthesis of the Evidence

    Issue Brief

    Congressional debates about the Medicare Sustainable Growth Rate (SGR) raise questions about whether doctors are willing to see Medicare patients. This issue brief examines multiple data sources to assess beneficiaries’ access to physicians, particularly vulnerable beneficiaries with greater health needs and other disadvantages. It examines the share of doctors who are participating physicians as well as those who have opted-out of the Medicare program to privately contract with Medicare patients. It includes State analyses of…

  • How Much Will Medicaid Physician Fees for Primary Care Rise in 2013? Evidence from a 2012 Survey of Medicaid Physician Fees

    Issue Brief

    This brief presents 50-state data from the 2012 KCMU/Urban Institute Medicaid Physician Fee Survey. It estimates that average Medicaid fees to qualified physicians for Affordable Care Act primary care services will rise by 73 percent when the primary care fee increase takes effect on January 1, 2013, although there will be wide state variation. The paper presents data showing how states compare in their 2012 Medicaid fee levels, how Medicaid fees compared to Medicare fees,…

  • Increasing Medicaid Payments for Certain Primary Care Physicians in 2013 and 2014: A Primer on the Health Reform Provision and Final Rule

    Issue Brief

    To help ensure that access in Medicaid expands to meet anticipated higher demand for care, the health reform law requires states to pay certain physicians Medicaid fees that are at least equal to Medicare’s for a list of 146 primary care services in 2013 and 2014. The idea is to attract new physicians to Medicaid and provide greater support for physicians who already participate. As a result, Medicaid fees paid to certain physicians for primary…

  • Physician Willingness and Resources to Serve More Medicaid Patients: Perspectives from Primary Care Physicians

    Issue Brief

    This issue brief attempts to assess how primary care physicians will respond to the entry of 32 million newly insured people into the health care system under health reform. The increase in the number of people with health coverage is expected to intensify competition among patients and payers for primary care resources. The brief analyzes data from a nationally representative survey of physicians to assess which adult-care primary care physicians are most likely to respond…

  • Improving Access to Adult Primary Care in Medicaid: Exploring the Potential Role of Nurse Practitioners and Physician Assistants

    Issue Brief

    The inadequate supply of primary care providers is among the major challenges facing the U.S. health care system. Sixty-five million people live in areas designated by the federal government as having a shortage of primary care providers. Under the Patient Protection and Affordable Care Act (ACA), the pressures on access are certain to grow as millions of newly insured people enter the health care system. By 2020, the U.S. will face an estimated shortage of…