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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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  • 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;…

  • Inside Deficit Reduction: What It Means for Medicare

    Event Date:
    Event

    Proposals to generate Medicare savings abound, from the various commissions recommending change, members of Congress and others. Which proposals will, or should receive serious considerations by the Congressional super committee in its quest to find $1.2 trillion or more in savings by its November 23 deadline? What impact would these changes have on beneficiaries, providers and insurers? Would stakeholders prefer the automatic, but capped, Medicare reductions in the sequester rather than any recommendations on Medicare…

  • Medicare Part D 2011 Data Spotlights

    Report

    The Kaiser Family Foundation has issued a collection of analyses related to the Medicare Part D stand-alone drug plan options available to seniors for calendar year 2011. 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 and the Kaiser Family Foundation. 2012 Part D Data Spotlights Now Available…

  • Medicare Part D Data Spotlight: A First Look at Part D Plan Offerings in 2012

    Report

    This data spotlight examines the stand-alone Part D drug plan options available to Medicare beneficiaries in 2012. Medicare beneficiaries will, on average, be able to choose from 31 stand-alone Medicare Part D prescription drug plans to choose from, a new Kaiser analysis finds. Average premiums would increase by 4 percent from 2011 to 2012 if beneficiaries remain with their current plans during the open enrollment period, which begins October 15 and December 31. That represents…

  • Analysis of Medicare Prescription Drug Plans in 2011 and Key Trends Since 2006

    Report

    This report presents findings from an analysis of the Medicare Part D marketplace in 2011 and changes in drug coverage and costs since 2006. It presents key findings related to Medicare drug plan premiums, the subsidy 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 Jack Hoadley and Laura Summer of Georgetown…

  • Inside Deficit Reduction: What it Means for Health Care

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    Event

    After much heated debate on the U.S. debt limit, the Budget Control Act of 2011 was passed on August 2, 2011, containing more than $900 billion in federal spending reductions over 10 years. The law also established the 12-person “super committee” charged with finding more than $1 trillion in additional savings. What exactly is called for in the law? What are the implications for health care programs, including Medicare, Medicaid, CHIP and the Patient Protection…

  • Medicare Advantage 2011 Data Spotlight: Medicare Advantage Enrollment Market Update

    Issue Brief

    This data spotlight examines enrollment trends in Medicare Advantage plans in 2011 and finds that, despite concerns about the effects of the 2010 health reform payment reductions on private Medicare Advantage plans, enrollment continued to rise this year. Additionally, Medicare Advantage enrollees are paying lower premiums, on average, than they did in 2010. Preferred Provider Organizations gained more enrollees than any other plan type, while enrollment in Private Fee-for-Service plans continued to decline. A companion…

  • Firm Perspectives on the Medicare Advantage Market

    Issue Brief

    Based on interviews with senior executives at 14 large firms, the issue brief finds that insurers anticipate continuing to offer Medicare Advantage plans in 2012, in part because of a Medicare demonstration project that will award bonus payments to plans based on their quality standards. A companion issue brief examines trends in Medicare Advantage enrollment in 2011. The analysis was conducted by researchers at Mathematica Policy Research, Inc. and the Kaiser Family Foundation. Issue Brief…

  • Medicare Advantage 2011 Data Spotlights

    Report

    Now Available: 2012 Medicare Advantage Spotlight: Plan Availability and Premiums The Kaiser Family Foundation has issued a series of data spotlights and issue briefs examining the Medicare Advantage plan options available in 2011 and trends affecting the Medicare Advantage marketplace. These analyses were prepared by researchers at Mathematica Policy Research, Inc. and the Kaiser Family Foundation. Medicare Advantage Enrollment Market Update Firm Perspectives on the Medicare Advantage Market Plan Availability and Premiums

  • Special Needs Plans: Availability and Enrollment

    Report

    Special Needs Plans are a form of Medicare Advantage plan authorized to provide a managed care option for beneficiaries with significant or relatively specialized care needs, including Medicare beneficiaries who are dually eligible for Medicare and Medicaid, beneficiaries living in nursing homes or other institutions, and beneficiaries with severe chronic or disabling conditions. This data spotlight examines availability and enrollment trends for Special Needs Plans, which account for a small share of enrollment today but…