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.

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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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  • Retiree Health Trends and Implications of Possible Medicare Reforms – Fact Sheet

    Fact Sheet

    Retiree Health Trends And Implications Of Possible Medicare Reforms September 1997 Approximately 12 million of Medicare's 39 million beneficiaries receive employer-sponsored retiree health benefits as a supplement to their Medicare coverage. In addition, millions of retired workers under age 65 rely on retiree health benefits as their primary source of health insurance coverage. While employer-sponsored health insurance is an important source of coverage for current retirees, health benefits for future retirees are uncertain. Retiree Health…

  • The President’s FY 2007 Budget Proposal: Overview and Briefing Charts

    Report

    This chartpack reviews the President’s FY 2007 budget request to Congress and highlights overall budget assumptions and funding for major health programs. It begins with a description of the federal budget process, followed by summary information on the overall composition of the Administration’s budget. Overall, the budget includes net reductions for Medicare, Medicaid, and other health programs administered by the Department of Health and Human Services. The budget also includes additional expenditures for proposals to…

  • KFF Articles in the Journal Generations: Medicare at 50

    Report

    Published in a special Summer 2015 edition of the journal Generations on Medicare's 50th anniversary, these six articles by KFF staff reflect on Medicare’s history, evolution and future, including a look at lessons and challenges, the Medicare and Medicaid partnership, coverage, the role of private plans, Medicare's role for women, and the public opinion about the program.

  • Toplines: December 2005 Kaiser Health Poll Report

    Poll Finding

    Toplines: December 2005 Kaiser Health Poll Report These toplines provide the complete survey questions and responses to the December 2005 Kaiser Health Poll Report Survey, a bimonthly survey designed to provide key tracking information on public opinion about health care topics. The survey includes a series of questions on seniors' views of the new Medicare prescription drug benefit. Survey Toplines (.pdf)

  • Toward Making Medicare Work for Low-Income Beneficiaries: A Baseline Comparison of the Part D Low-Income Subsidy and Medicare Savings Programs Eligibility and Enrollment Rules

    Report

    Toward Making Medicare Work for Low-Income Beneficiaries: A Baseline Comparison of the Part D Low-Income Subsidy and Medicare Savings Programs Eligibility and Enrollment Rules This report examines how the low-income provisions of the Medicare drug benefit interact with state-level assistance provided through the Medicare Savings Program. The Medicare drug benefit provides additional help with premiums and cost-sharing requirements for eligible, low-income beneficiaries. The Social Security Administration oversees enrollment in this program. Separately, each state runs…

  • Early Experiences of Medicare Beneficiaries in Prescription Drug Plans

    Report

    This report offers insights into Medicare beneficiaries’ experiences with the new drug benefit, based on observations of State Health Insurance Assistance Plan (SHIP) directors convened for a moderated focus group discussion. Because SHIP directors work closely with the Centers for Medicare and Medicaid Services and are on the front lines providing one-on-one counseling for beneficiaries who have questions or problems related to the new drug benefit, they are a key resource for understanding issues that…

  • Medicare Consumer-Directed Health Plan: Medicare MSAs and HSA-like Plans in 2007

    Issue Brief

    Medicare Consumer-Directed Health Plan: Medicare MSAs and HSA-like Plans in 2007 This March 2007 issue brief, commissioned by the Kaiser Family Foundation, examines the development of consumer-directed health plans in the Medicare program. Medicare Medical Savings Account plans have high deductibles accompanied by a personal savings account that can be used to pay for medical expenses. The paper examines how such plans operate in Medicare, how they differ from other types of Medicare Advantage plans…

  • Medicare Advantage Chartpack

    Report

    These charts highlight key data about the Medicare Advantage program, which has grown rapidly in terms of enrollment and number of plans since the enactment of the Medicare Modernization Act in 2003. The package includes a map showing Medicare Advantage penetration by state as well as key facts about private fee-for-service plans, which have contributed significantly to the recent growth of the Medicare Advantage program. Chartpack (.pdf)

  • The Impact of Part D on Dual Eligibles Who Spend-Down to Medicaid

    Issue Brief

    Individuals with incomes exceeding thresholds for regular Medicaid eligibility may qualify under state medically needy programs by spending down excess income on healthcare services. For the vulnerable population of Medicare beneficiaries who spend down to Medicaid, the Part D transition has added additional complexities that may result in disruptions in pharmacy coverage and add financial burdens. This paper explores the inter-relationship of Medicare prescription drug coverage and Medicaid spend-down for the medically needy. It describes…

  • The Role of State Pharmaceutical Assistance Programs in Serving Low-Income Medicare Beneficiaries Following the Implementation of Medicare Part D

    Issue Brief

    The Role of State Pharmaceutical Assistance Programs in Serving Low-Income Medicare Beneficiaries Following the Implementation of Medicare Part D Prior to January 1, 2006, State Pharmaceutical Assistance Programs helped to fill a critical gap in coverage for Medicare beneficiaries without prescription drug coverage, targeting resources to beneficiaries with relatively low incomes. With the inception of the Medicare prescription drug benefit, the role of SPAPs began to change. This policy brief examines the role of state…