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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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  • Seniors' Knowledge and Experience With Medicare's Open Enrollment Period and Choosing a Plan: Key Findings from the Kaiser Family Foundation 2012 National Survey of Seniors

    Issue Brief

    These key findings from the Foundation's 2012 National Survey of Seniors relate to seniors’ knowledge and experience with Medicare’s open enrollment period and choosing a plan. The survey finds one in four seniors say they are unaware of this annual opportunity to review and change their Medicare coverage, with even larger shares who say they are unaware of Medicare’s open enrollment period among blacks and Hispanics and those seniors in fair or poor health, with…

  • Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

    Issue Brief

    Massachusetts is the first state to finalize a memorandum of understanding (MOU) with the Centers for Medicare and Medicaid Services (CMS) to test CMS's capitated financial alignment model for beneficiaries who are dually eligible for Medicare and Medicaid, with enrollment beginning on April 1, 2013. Starting in 2013, CMS will implement a three-year multi-state demonstration to test new service delivery and payment models for people who are eligible for both federal health programs. Massachusetts' demonstration…

  • Polling on Medicare Premium Support Systems Over Time

    Poll Finding

    This data note reviews years of polling dating to 1995 to gauge public opinion on proposals to change Medicare to a premium support system, an idea embraced by GOP presidential nominee Governor Mitt Romney and rejected by President Obama. Under the proposed change, the federal government would provide people on Medicare a fixed amount of money that could be applied toward the cost of health insurance purchased either from private insurers or the traditional Medicare…

  • State Demonstrations to Integrate Care and Align Financing for Dual Eligible Beneficiaries: A Review of the 26 Proposals Submitted to CMS

    Report

    The Centers for Medicare and Medicaid Services (CMS) has proposed two models to align Medicare and Medicaid benefits and financing for dual eligible beneficiaries, one capitated model and one managed fee-for-service model. In the spring of 2012, 26 states submitted proposals to CMS seeking to test one or both of these models. CMS is presently reviewing the states' proposals to determine which will be implemented. This background paper examines the contents of the 26 states'…

  • Transforming Medicare into a Premium Support System: Implications for Beneficiary Premiums

    Report

    This study illustrates why geography would matter for Medicare beneficiaries under a premium support system that relies on a competitive bidding process envisioned under several key Medicare reform proposals. It examines potential changes in the premiums paid by Medicare beneficiaries under a payment approach that caps federal contributions per beneficiary based on the cost of the second lowest-bidding private plan or traditional Medicare, whichever is lower in their area. Under this approach, beneficiaries can choose…

  • Explaining the State Integrated Care and Financial Alignment Demonstrations for Dual Eligible Beneficiaries

    Issue Brief

    This paper provides an overview of the joint efforts of states and the Centers for Medicare and Medicaid Services (CMS) to develop more integrated ways of paying for and delivering health care to the 9 million people who are eligible for both the Medicare and Medicaid programs. Dual eligible beneficiaries comprise many of the poorest and sickest people covered by either program, and they account for a disproportionately large share of Medicare and Medicaid spending.…

  • How the ACA Changes Pathways to Insurance Coverage for People with HIV

    Perspective

    There are multiple sources of insurance coverage and care for people with HIV in the United States.  These include public programs, such as Medicaid and Medicare, and the Ryan White HIV/AIDS program, as well as private coverage through an employer or in the individual market. Medicaid, the nation's principal safety-net health insurance program for low-income Americans, is estimated to cover the largest share of people with HIV. Fewer are covered by Medicare, the federal health…

  • Kaiser Health Tracking Poll: September 2012

    Feature

    The September poll finds with the November election fast-approaching, Medicare trails only the economy and the federal budget deficit as key priorities for voters, and interest in the federal health program is even higher among seniors. More than a third (36%) of Americans say Medicare is “extremely” important to their vote in the election, compared to 49 percent who describe the economy in such terms and 41 percent who say so about the federal budget…

  • Analysis of Medicare Prescription Drug Plans In 2012 And Key Trends Since 2006

    Report

    This report presents findings from an analysis of the Medicare Part D marketplace in 2012 and changes in drug coverage and costs since 2006. It presents key findings related to Medicare drug plan plan availability, premiums, cost-sharing, the coverage gap and availability for low-income beneficiaries, the coverage gap, benefit design and cost sharing, formularies, and utilization management, based on data from CMS for all plans participating in Part D. The analysis was conducted jointly by…

  • Medicare Part D 2012 Data Spotlights

    Report

    The Kaiser Family Foundation has issued this collection of analyses related to the Medicare Part D stand-alone drug plan options available to seniors in 2012. These spotlights focuses on key aspects of the drug plan choices available and relevant trends since the Medicare drug benefit took effect in 2006. They were prepared by a team of researchers at Georgetown University, NORC at the University of Chicago and the Kaiser Family Foundation. Analysis Of Medicare Prescription…