Medicare

NEW AND NOTEWORTHY

Examining the Potential Impact of Medicare’s New WISeR Model

A federal initiative to establish new prior authorization requirements in traditional Medicare, called the Wasteful and Inappropriate Service Reduction (WISeR) model, is likely to have only modest impact in its first year.

State Profiles for Dual-Eligible Individuals

This data collection draws on Medicare and Medicaid administrative data to present national and state-level information on people who are covered by both Medicare and Medicaid, referred to as dual-eligible individuals (also known as dually-enrolled beneficiaries).

Data Visualization

The Facts About Medicare Spending

This interactive provides the facts on Medicare spending. Medicare, which serves 67 million people and accounts for 12 percent of the federal budget and 21 percent of national health spending, is often the focus of discussions about health expenditures, health care affordability and the sustainability of federal health programs. Explore data on enrollment growth, Medicare spending trends overall and per person, growth in Medicare spending relative to private insurance, spending on benefits and Medicare Advantage, Part A trust fund solvency challenges, and growth in out-of-pocket spending by beneficiaries.

Read More

Stay informed.

Stay informed.

Filter

991 - 1,000 of 1,605 Results

  • External Review of Health Plan Decisions: An Overview of Key Program Features in the States and Medicare

    Report

    In 1978, the state of Michigan established a system to call on independent medical experts to help resolve disputes between health plans and patients about the medical necessity and appropriateness of care. Since then, twelve other states and the Medicare program have established similar kinds of external review programs. In the first half of 1998, five more states enacted external review laws (and two states passed laws modifying or expanding existing programs). The term "external…

  • Do We Know If Medicare Advantage Special Needs Plans Are Special?

    Report

    This report describes the history of special needs plans, how they fit into the larger Medicare Advantage marketplace, and what information could help assess whether these plans are performing differently from other Medicare Advantage plans. Special needs plans serve individuals such as those who are institutionalized, people covered under both Medicare and Medicaid, or those with chronic or disabling conditions. Enrollment in these plans doubled in the past year, and President Bush recently signed the…

  • How Much ‘Skin In The Game’ Do Medicare Beneficiaries Have? The Increasing Financial Burden of Health Care Spending, 1997-2003

    Issue Brief

    This study evaluated the changes in Medicare beneficiaries' health care spending between 1997 and 2003, and found beneficiaries spent a growing share of their income on health care. The results showed that median out-of-pocket health spending increased from 11.9% of income in 1997 to 15.5% in 2003, and about four in 10 beneficiaries spent at least one-fifth of their income on health care in 2003. Researchers using data from the Medicare Current Beneficiary Survey found…

  • Visualizing Health Policy: The Role of Medicaid and Medicare in Women’s Health Care

    Other Post

    This month’s Visualizing Health Policy infographic provides information about the role of Medicaid and Medicare in women’s health care: the proportion of US women who are covered by Medicaid and Medicare; how women comprise the majority of those covered by the Medicaid and Medicare programs and the majority of those receiving long-term services and supports (such as home health care); how women on Medicaid are poorer and sicker than women with private coverage; how Medicaid…

  • Medicare Advantage 2013 Spotlight: Enrollment Market Update

    Issue Brief

    This Data Spotlight provides an overview of Medicare Advantage enrollment patterns in March 2013, and examines variations by plan type, state, and firm. It also analyzes trends in premiums paid by beneficiaries enrolled in Medicare Advantage plans, including variations by plan type, and describes the out-of-pocket limits and prescription drug coverage in the Part D “donut hole” provided by the plans in 2013.

  • Medicare: The Essentials

    Feature

    Medicare: The Essentials (July 2013) Download Medicare Enrollment, 1966-2013 Download Source Centers for Medicare & Medicaid Services, Medicare Enrollment: Hospital Insurance and/or Supplemental Medical Insurance Programs for Total, Fee-for-Service and Managed Care Enrollees as of July 1, 2011: Selected Calendar Years 1966-2011; 2012-2013, HHS Budget in Brief, FY2014. Medicare Beneficiaries as a Percent of State Populations, 2012 Download Source Calculation based on Kaiser Family Foundation analysis of the CMS State/County Market Penetration file, March 2012;…

  • The Future of Medicare Advantage: Are We on the Right Path?

    Event Date:
    Event

    This June 10 briefing looked at Medicare Advantage and changes affecting it, including revised calculations of payments from CMS, and the Affordable Care Act's reduced payments to Medicare Advantage plans. Speakers discussed how Medicare Advantage plans are expected to respond to payment changes; if quality bonus payments created significant changes in patient care or plan choices; and what implications could these decisions have on beneficiaries with regard to premiums, benefits and more.