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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  • 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…

  • May 13 Briefing: How Well Are Seniors Making Choices Among Medicare’s Private Plans And Does It Matter?

    News Release

    The typical Medicare beneficiary this year has 18 private Medicare Advantage plans and 35 stand-alone Part D drug plan options to consider, in addition to traditional Medicare. Medicare encourages seniors to make informed decisions with respect to their health coverage options when they first become eligible for Medicare, and to review these options annually so they select coverage that best meet their needs. Yet research suggests only a small share of Medicare beneficiaries voluntarily switch…

  • What’s In and What’s Out? Medicare Advantage Market Entries and Exits for 2015

    Issue Brief

    This Data Note examines the availability of plans nationwide and by state in 2015, and changes in plan availability since 2011. It documents the number and share of Medicare Advantage enrollees affected by plan withdrawals each year, the characteristics of plans that will be entering the market and characteristics of those exiting the market in 2015.

  • Retiree Health Benefits At the Crossroads

    Report

    This issue brief 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 (ACA) on retiree health coverage. The report describes leading strategies employers have been pursuing or considering to limit costs for retiree health benefits. In addition, the report considers the potential implications of proposals aimed at reducing federal spending for retiree health coverage and costs.

  • Visualizing Health Policy: The Role of Medicare Advantage

    Other Post

    This September 2014 Visualizing Health Policy Infographic examines the role of private plans, such as HMOs and PPOs, in Medicare. These Medicare Advantage plans offer an alternative to traditional Medicare and provide all benefits covered under Medicare Parts A and B, and often Part D. The infographic includes data on Medicare Advantage penetration across the country. It shows the concentration of enrollment among a small number of firms and affiliates, and displays the extent to…

  • Health Affairs Blog: Medicare Premium Support Proposals Could Increase Costs for Today’s Seniors, Despite Assurances

    Perspective

    In a Health Affairs blog post, Tricia Neuman and Gretchen Jacobson of the Kaiser Family Foundation examine how proposals to convert Medicare to a premium support system could lead to higher Medicare premiums and cost-sharing for seniors currently enrolled in the program, even if today’s seniors are “grandfathered” and the new system is phased-in for people ages 55 and younger. The blog post explains how today’s seniors could face higher health care costs, if older…

  • Possibilities and Limits of Telehealth for Older Adults During the COVID-19 Emergency

    Policy Watch

    Medicare has lifted several restrictions on who can receive telehealth and the types of services they can receive via telehealth during the COVID-19 public health emergency. This post discusses the possibilities and limits of telehealth for older adults, based on findings from the latest KFF Health Tracking Poll.

  • Insulin Costs and Coverage in Medicare Part D

    Issue Brief

    In light of heightened attention to insulin and the Trump Administration’s new Part D model to address out-of-pocket costs for insulin for Medicare beneficiaries, we analyzed out-of-pocket spending on insulin by beneficiaries enrolled in Part D drug plans, variation in Part D plan formulary coverage and tier placement of insulin products, and trends in prices for insulin.

  • Medicare Part D: A First Look at Prescription Drug Plans in 2020

    Issue Brief

    This issue brief provides an overview of the Medicare Part D prescription drug benefit plan landscape for 2020, with a focus on stand-alone drug plans, the largest segment of the Part D market. It includes national and state-level data on plan availability, premiums, benefit design, cost sharing, information about premium-free plans for low-income beneficiaries, and information about the national Part D plans available in 2020.