ACOs are groups of doctors, hospitals, and other health care providers who voluntarily form partnerships to collaborate and share accountability for the quality and cost of care delivered to their patients. These FAQs describe the ACO models in Medicare and answer questions pertaining to spending and quality results, where models are located, and how many beneficiaries are involved. These Medicare accountable care organization (ACO) FAQs are part of the Medicare Delivery System Reform Evidence Link.
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Medical homes are typically team-based primary care practices that provide the majority of their patients’ health care needs either directly, or through coordination with other providers. These FAQs describe the medical home models in Medicare, and answer questions pertaining to spending and quality results, where models are located, and how many beneficiaries are involved. These Medicare medical home FAQs are part of the Medicare Delivery System Reform Evidence Link.
Bundled payment models are a way for Medicare to establish a total budget for all services provided to a beneficiary throughout an episode of care. These FAQs describe the different types of Medicare bundled payment models, and answer questions pertaining to spending and quality results, where models are located, and how many beneficiaries are involved. These Medicare bundled payment FAQs are part of the Medicare Delivery System Reform Evidence Link.
The Kaiser Family Foundation’s Evidence Link is an interactive resource that pulls together the latest available evidence on Medicare payment and delivery system reform models, with an initial focus on accountable care organization (ACO), medical home, and bundled payment models. Through FAQs and side-by-side comparison tables, the Evidence Link synthesizes the most up-to-date information on savings and quality results, and describes key design features of each Medicare model, such as how providers are paid, the number of beneficiaries receiving care under each model, where models are being tested, and timelines for evaluations.
This tutorial walks users through the Medicare Delivery System Reform Evidence Link, including its FAQs and side-by-side comparison tables on Medicare accountable care organization (ACO), medical home, and bundled payment models.
Keep current with Medicare Payment and Delivery System Reform news, including recently-proposed rules, newly-released spending and quality results, and announcements on model changes.
One Million Medicare Part D Enrollees Had Out-of-Pocket Drug Costs above the Catastrophic Threshold in 2015
One million Medicare beneficiaries had out-of-pocket drug spending above the Part D catastrophic threshold in 2015, and the number with such high spending has risen sharply in recent years, according to a new analysis by the Kaiser Family Foundation. While the Part D drug benefit has helped make drugs more…
No Limit: Medicare Part D Enrollees Exposed to High Out-of-Pocket Drug Costs Without a Hard Cap on Spending
The Medicare Part D prescription drug benefit has helped improve the affordability of medications for people with Medicare, but enrollees can face relatively high out-of-pocket drug costs because there is no hard cap on out-of-pocket spending under Part D. This analysis examines out-of-pocket prescription drug spending among Medicare Part D enrollees with costs above the catastrophic coverage threshold.
The Independent Payment Advisory Board was authorized by the Affordable Care Act to help slow the growth in Medicare spending. These FAQs address common questions about IPAB, including how it was designed to operate and the implications of eliminating it.
Most people with Medicare pay the standard monthly premium for Part B and Part D coverage, which is set to cover 25 percent of Part B and Part D program costs, but a relatively small share of beneficiaries are required to pay higher premiums. This issue brief describes current requirements with respect to Medicare’s Part B and Part D income-related premiums and proposed changes under House legislation being considered in November 2017.