Medicare

NEW AND NOTEWORTHY

What to Know About Medicare Coverage of Telehealth

Congress has repeatedly extended pandemic-era flexibilities around Medicare coverage of telehealth, but most such flexibilities remain temporary. This brief answers key questions about the current scope of Medicare telehealth coverage, including both temporary and permanent changes adopted through legislation and regulation, and future policy considerations.

Changes to the Medicare Advantage Program Enhance Some Consumer Protections But Roll Back Others

CMS recently finalized policies as part of the 2027 Medicare Advantage final rule that both enhance consumer protections and roll back changes to the Medicare Advantage program that were intended to protect consumers. These changes have gotten less attention than payment issues and changes to the star ratings system, which also affect plan payments, but could have implications for Medicare beneficiaries.

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. u003cbru003eu003cbru003eExplore 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.u003cbru003eu003cbru003eu003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022 data-type=u0022linku0022 data-id=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003eRelated:u003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003e FAQs on Medicare Financing and Trust Fund Solvencyu003c/au003eu003c/au003e

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  • Kaiser Health Tracking Poll — February 2012

    Feature

    In the midst of continuing debate on the future of the Medicare program, the February Kaiser Family Foundation Tracking Poll finds most Americans and most seniors favor the status quo, though arguments about the program’s solvency have the potential to sway opinion toward new proposals. The survey also gauges public opinion about the ongoing contraceptive coverage debate, views of the Affordable Care Act, and trust in the presidential candidates on health care issues. The February…

  • Betting on Private Insurers

    Perspective

    Just-released estimates of national health spending in 2010 by the Centers for Medicare and Medicaid Services (CMS) show that 45% of our health care spending is financed by the federal and state governments, primarily through the Medicare and Medicaid programs. This share has grown temporarily in recent years because of the economic downturn, as private insurance has declined and Medicaid has grown. It has also increased due to our demographic destiny: the growing cohort of baby…

  • Talking About Medicare: Your Guide to Understanding the Program, 2012

    Report

    Medicare is the federal health insurance program for people 65 and older and for some younger adults with permanent disabilities and medical conditions.  Prior to 1965, the year in which the Medicare program was established, about half of all seniors lacked health insurance.  Today, virtually all people 65 and older have coverage under Medicare, and are eligible for this coverage without regard to their income or medical history.  Medicare currently provides health insurance coverage for…

  • Pulling it Together: 2012: The ACA, and More

    From Drew Altman

    What is remarkable about 2012 (and the current era in health policy) is how many big health policy issues and marketplace changes will be in play at the same time: HEALTH REFORM: There is the implementation of a historic but fragile health reform law, with a Supreme Court decision pending and so much hanging in the balance. MEDICARE AND MEDICAID: There are continuing debates about potentially big changes in Medicare and Medicaid, driven by the…

  • Integrating Care for Dual Eligibles: What Do Consumers Want?

    Event Date:
    Event

    Many deficit reduction plans have recognized the need to improve care for the 9 million beneficiaries dually eligible for Medicare and Medicaid. How do Medicaid and Medicare coordinate payment and care for people covered by both programs? Are Health and Human Services initiatives encouraging innovations to integrate care for dual eligible beneficiaries? What kind of programs are currently available? What do consumers think about different ways of getting care? What lessons for program design can…

  • The Ups and Downs of Medicare Part B Premiums: Frequently Asked Questions

    Issue Brief

    This brief examines how Medicare Part B premiums for many beneficiaries are affected by the annual cost-of-living adjustment (COLA) for Social Security benefits. Based on the most recent projections from the Medicare and Social Security Trustees, the brief examines the interactions between the two programs that resulted in some Medicare beneficiaries paying significantly higher Part B premiums in 2010 and 2011 when there was no Social Security COLA, followed by a drop in premiums in…

  • Financial Alignment Models for Dual Eligibles: An Update

    Issue Brief

    The nearly nine million dual eligibles who receive both Medicare and Medicaid benefits are a high cost, high need population, accounting for a disproportionate share of expenditures relative to their enrollment in both programs. In April 2011, the Centers for Medicare and Medicaid Services (CMS) announced the award of design contracts to 15 states to develop service delivery and payment models to integrate care for dual eligibles. CMS and the participating states have recognized that…

  • Medicare Advantage 2012 Spotlight: Plan Availability and Premiums

    Report

    This brief highlights trends in the Medicare Advantage marketplace, including the choices available to Medicare beneficiaries in 2012, premium levels and other plan characteristics. The brief was authored by researchers at Mathematica Policy Research and the Kaiser Family Foundation. Data Spotlight (.pdf)

  • Medicare Advantage Plan Star Ratings and Bonus Payments in 2012

    Report

    This report looks at the star ratings that have been used for many years to help consumers compare plans, and examines how Medicare Advantage quality scores will interact with plan payments, beginning in 2012. To encourage Medicare Advantage plans to provide quality care, the 2010 health reform law authorized Medicare to pay plans bonuses beginning in 2012 if they receive four or five stars on the program’s five-star quality rating system, or are unrated. Building…

  • Restructuring Medicare’s Benefit Design: Implications for Beneficiaries and Spending

    Report

    Several deficit-reduction plans have proposed combining Medicare's separate deductibles for hospital and physician services, standardizing cost sharing across types of benefits, and establishing a new limit on annual out-of-pocket costs for beneficiaries. A new Kaiser Family Foundation study examines the potential implications of proposals to revamp Medicare’s cost-sharing requirements as a way of reducing federal spending. The analysis projects what would happen if Medicare's current benefit design were replaced with a unified deductible of $550;…