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Decoding Medicare Advantage Coding Intensity

Federal payments to Medicare Advantage plans, and adjustments for health status, have come under increased scrutiny. This brief answers key questions about coding intensity, recent steps taken by CMS, the effects on beneficiaries, and other proposals to improve payment accuracy.

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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.

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  • Report Examines Current Role and Future Outlook of Retiree Health Coverage

    News Release

    A new Kaiser Family Foundation report examines the current role and future outlook of employer-sponsored retiree health benefits for pre-65 and Medicare-eligible retirees. Retiree Health Benefits At the Crossroads reviews recent trends and developments in employer-sponsored retiree health coverage and examines the impact of recent legislation, such as the Medicare drug benefit and the Affordable Care Act, on retiree health coverage. The report describes leading strategies employers have been pursuing to limit costs associated with…

  • Medicare Advantage: Take Another Look 

    News Release

    In the latest post in the Policy Insights series, Tricia Neuman and Gretchen Jacobson examine the surprising growth in Medicare Advantage enrollment following payment reductions included in the Affordable Care Act. Previous columns in the Policy Insights series are also available on kff.org.

  • The Policy Implications of Medicare’s New Measure of Financial Health

    Issue Brief

    This report examines a new measure of Medicare’s financial health established by the Medicare Prescription Drug, Improvement and Modernization Act of 2003 (MMA). The report, authored by Marilyn Moon, takes an in-depth look at the program’s new solvency test, which measures general revenues as a share of total Medicare spending and can trigger a “funding warning” that compels the President to propose and the Congress to consider a funding warning.

  • Medicare Part D Spending on the EpiPen Increased More than 1000 Percent from 2007 to 2014

    News Release

    As policymakers in Washington scrutinize the rising cost of the EpiPen auto-injector, a new analysis from the Kaiser Family Foundation shows that Medicare Part D spending for the potentially life-saving device increased by more than 1000 percent between 2007, the year after the Part D drug benefit took effect, and 2014, the most recent year for which data are available. The higher spending partly results from more Part D enrollees using EpiPens during that period,…

  • Policy Insight Examines How Current Rules May Deter Seniors From Switching from Medicare Advantage to Traditional Medicare and Implications for Medicare’s Future

    News Release

    In this new policy insight, the Kaiser Family Foundation’s Tricia Neuman examines current rules that may discourage seniors from switching from Medicare Advantage to traditional Medicare.Traditional Medicare…Disadvantaged? explores this issue through the lens of a 67-year old Boomer who faced difficult financial and health coverage choices in the aftermath of a serious mountain biking accident. Previous columns in the Policy Insights series are also available.

  • Medicare Payment System Reforms: What Do We Know?

    Event Date:
    Event

    Medicare is testing new ways to pay for medical services, emphasizing value rather than volume, and evidence is beginning to build about successes and challenges. On Monday, April 11, the Kaiser Family Foundation (KFF) and the Alliance for Health Reform will host a briefing to examine what we know so far about the basic models, savings, quality, the impact on patients and the prospects for replication. Moderated by KFF’s Tricia Neuman and the Alliance’s Marilyn Serafini, Monday's discussion will…

  • ¿Cómo puedo averiguar si mi médico acepta Medicare?

    FAQs

    La mayoría de los médicos en los Estados Unidos aceptan Medicare. Para encontrar una lista de médicos en su área que reciben Medicare y aceptan no facturarle más del monto que Medicare aprueba por su visita, vaya al sitio web de Comparación de Médicos (Phsysician Compare) de Medicare y busque una marca de verificación junto a "pago aprobado" (Accepts Medicare Assignment). Si no tiene acceso a una computadora, también puede llamar al 1-800-MEDICARE (1-800-633-4227), o…

  • Tengo 54 años y vivo con una discapacidad permanente. Durante los últimos 12 meses he estado recibiendo pagos del Seguro Social por Discapacidad (SSDI). Pero no tengo seguro de salud. Debo esperar otros...

    FAQs

    Sí, usted es elegible para comprar cobertura a través del mercado de seguros, y si su ingreso está entre el 100% y el 400% de la pobreza (para comprar cobertura en el mercado en 2026, lo que significa $15,650 para una persona), calificará para créditos fiscales para las primas para ayudar a que la cobertura del mercado sea más asequible. Si vive en un estado que ha ampliado su programa de Medicaid para cubrir a…

  • Quiero cambiarme de Medicare Advantage a Medicare tradicional, pero aún quiero cobertura de medicamentos. ¿Qué tengo que hacer?

    FAQs

    Si cambia de un plan Medicare Advantage al Medicare tradicional y desea cobertura de medicamentos, puede inscribirse durante el Período de Inscripción Abierta de Medicare para obtener un plan de medicamentos recetados independiente en su área. Su nueva cobertura entrará en vigencia el 1 de enero. También puede cambiarse de Medicare Advantage a Medicare tradicional durante el período de inscripción abierta de Medicare Advantage entre el 1 de enero y el 31 de marzo, cuando…

  • ¿Cómo puedo comparar mis opciones de cobertura de Medicare?

    FAQs

    Puede comparar sus opciones de cobertura de Medicare usando una herramienta de búsqueda en línea en el sitio web Medicare.gov, incluidos los planes Medicare Advantage, los planes de la Parte D de Medicare y las pólizas complementarias de Medigap. Puede obtener información sobre la cobertura, los costos y los beneficios de diferentes opciones de cobertura en su área en el sitio para comparar coberturas de Medicare. También puede inscribirse en un plan Medicare Advantage o…