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.

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  • Transitions 2006

    Video

    On January 1, 2006, the six million Americans who are covered by both Medicare and Medicaid saw a change in how their prescription drugs are covered. The dual eligible population was transitioned from Medicaid into the Medicare prescription drug benefit. As a group, these beneficiaries are poorer and sicker than those on Medicare. Consequently, they have more extensive health and prescription drug needs than most Medicare beneficiaries.

  • An Analysis of the Share of Medicare Beneficiaries Who Would Benefit from an Annual Out-of-Pocket Maximum under Traditional Medicare Over Multiple Years

    Issue Brief

    This analysis examines the share of Medicare beneficiaries who would be helped over time if the program were to add a limit on out-of-pocket spending to traditional Medicare. This analysis was conducted jointly with the Medicare Payment Advisory Commission (MedPAC) in response to a request made during a Feb. 26, 2013 hearing of the House Ways and Means' Subcommittee on Health.

  • How Medicare Advantage Rebates Disadvantage Medicare’s Stand-Alone Drug Plan Market

    Issue Brief

    The private plans that offer the Medicare Part D benefit - stand-alone drug plans and Medicare Advantage drug plans - are increasingly are competing on uneven terms, in part because the payment system for Medicare Advantage plans enables them to lower Part D premiums or reduce Part D cost sharing, making drug coverage from Medicare Advantage plans appear considerably cheaper, or even premium-free, to the beneficiary. This brief discusses the growing instability of the Part…

  • Medicare Part D Enrollment, Premiums, and Cost Sharing in 2026

    Issue Brief

    The Medicare Part D program provides an outpatient prescription drug benefit to 56 million older adults and people with long-term disabilities in Medicare who enroll in private plans. This brief analyzes Medicare Part D enrollment, premiums, and cost sharing in 2026 and trends over time, based on data from the Centers for Medicare & Medicaid Services (CMS).

  • Medicare and Telehealth: Coverage and Use During the COVID-19 Pandemic and Options for the Future

    Issue Brief

    This brief provides an overview of changes in coverage of telehealth under traditional Medicare before the coronavirus pandemic, and estimates changes in use of telehealth services using survey data from the Medicare Current Beneficiary Survey (MCBS) during the pandemic. The analysis also discusses issues and questions related to extending telehealth coverage under traditional Medicare beyond the public health emergency.

  • Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2021

    Issue Brief

    The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans, including stand-alone drug plans and Medicare Advantage drug plans. This analysis provides the latest data about Part D enrollment, premiums, and cost sharing in 2021 and trends over time.

  • March 30 Web Event: Unsung Heroes: The Crucial Role – and Tenuous Circumstances – of Home Care Workers During the Pandemic

    Event Date:
    Event

    Even as the pandemic took a devastating toll on health care workers and older adults in the United States, many home care workers continued to report to work and provide vital care to vulnerable people despite the health risks to themselves and their own families. KFF’s Kaiser Health News and The John A. Hartford Foundation held an interactive web event on March 30 to examine the crucial roles home care workers have played for families during…

  • A Status Report on Prescription Drug Policies and Proposals at the Start of the Biden Administration

    Issue Brief

    This brief provides a status update on prescription drug final rules advanced by the Trump Administration in its final months related to Medicare, importation, and 340B pricing for insulin and epinephrine, and an overview of key drug pricing proposals related to Medicare and prescription drug prices generally that were voted on but not enacted in the previous Congress that may return to the forefront of health policy discussions in the coming years.