Medicare

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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.

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.

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  • Overview of Medicare Part D Organizations, Plans and Benefits By Enrollment in 2006 and 2007

    Report

    This chartpack provides detailed information about Medicare beneficiaries’ enrollment in the many private drug plans available to them in 2007. The charts demonstrate that a relatively small number of companies which captured the most enrollees in 2006, the new benefit’s first year, continued to lead in market share in the current year. In addition, most enrollees in 2007 are in plans without gap coverage – with about 11.8 million people potentially at risk for reaching…

  • Voices of Beneficiaries: Attitudes Toward Medicare Part D Open Enrollment for 2008

    Other Post

    This report focuses on the recent experiences of a group of 35 Medicare beneficiaries in the early years of the Medicare prescription drug benefit, including a number who were enrolled in a Medicare Part D drug plan in 2007. It looks at their attitudes about the open enrollment season for 2008, and their interest related to switching to a new Part D plan for 2008. It finds that most enrollees do not intend to reexamine…

  • Medicare Part D 2010 Data Spotlight: Premiums

    Report

    Medicare Part D helps cover the cost of outpatient prescription drugs for 27 million beneficiaries enrolled in private stand-alone prescription drug plans (PDPs) and Medicare Advantage prescription drug (MA-PD) plans. The majority of Part D enrollees pay a monthly premium for Medicare drug coverage. This data spotlight examines premiums for enrolling in Medicare's PDPs in 2010 and trends since 2006.  The spotlight is one in a series analyzing key aspects of the Medicare Part D…

  • Explaining Health Reform: Key Changes in the Medicare Advantage Program

    Issue Brief

    This brief examines the changes in the 2010 health reform law affecting the Medicare Advantage program, which gives beneficiaries the option of enrolling in private insurance plans for their Medicare benefits, instead of the traditional fee-for-service program. The reform law will gradually reduce Medicare payments to these plans to bring the average payment closer to the costs of traditional fee-for-service Medicare, while rewarding plans with high-quality ratings. The brief also describes new benefit requirements for…

  • Medicare and Prescription Drugs, Fact Sheet

    Fact Sheet

    This fact sheet, updated in April 2003, profiles current sources of prescription drug coverage among the Medicare population, describes the characteristics of beneficiaries who lack drug coverage and the implications of being without such coverage, and provides current data on prescription drug use and spending. Fact Sheet (.pdf)

  • Retiree Health Trends and Implications of Possible Medicare Reforms

    Fact Sheet

    The availability of employer-sponsored retiree health benefits from large companies has declined since 1991, according to a new study conducted for the Kaiser Family Foundation by Hewitt Associates LLC. The study also shows that the number of big businesses charging premiums, tightening eligibility requirements, encouraging use of managed care, and placing dollar caps on coverage increased. In addition, the report concluded that potential changes in the Medicare program, such as a higher eligibility age, could…

  • Individuals With Disabilities and their Experiences with Medicaid Managed Care

    Report

    Today, one out of every four disabled Medicaid beneficiaries receives health care through managed care. This Background Paper provides insights into how Medicaid managed care is working for individuals with disabilities, based on the findings from seven focus groups held in Florida and New Mexico. The key findings show that adults and children with disabilities feel alone in managing their health care and that important components of managed care - coordination and gatekeeping role that…

  • Medicaid-Related Provisions in the Ticket to Work and Work Incentives Improvement Act of 1999

    Report

    In December, the President signed into law the Ticket to Work and Work Incentives Improvement Act of 1999, which includes provisions that will give states additional options for extending Medicaid coverage to working disabled individuals. This memo presents an overview of the eligibility options offered under the new legislation (Publication #2187). A related publication, Medicaid Eligiblity for Individuals with Disabilities (Publication #2150), provides a general overview of federal Medicaid eligibility policy for the low-income disabled…