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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  • The Burden of Out-of-Pocket Health Spending Among Older Versus Younger Adults: Analysis from the Consumer Expenditure Survey, 1998-2003

    Issue Brief

    UPDATED: An updated version of this analysis is now available online. Recent policy debate has focused on the issue of rising health care costs and whether it might be possible to control costs by requiring consumers to pay a larger share of their health care costs out of pocket. While most of the policy discussion has focused on people of working age, rising health care costs and the burden of out-of-pocket spending also affects seniors,…

  • Access To Health Care:

    Report

    Promises and Prospects For Low-Income Americans This book explores critical issues affecting access to health care for low-income Americans by assessing the importance of expansions of health coverage for the poor, the emerging challenges providers who serve low-income and uninsured populations face in a rapidly evolving health care delivery system, and the effects of these changes on particularly vulnerable populations. Articles include: IntroductionMarsha Lillie-Blanton, Rose Marie Martinez, Barbara Lyons, Diane Rowland A Review Of The…

  • Dementia and Medicare Managed Care: A Growing Challenge for Health Plans

    Report

    The American Bar Association Commission on Legal Problems of the Elderly explored the views of Medicare HMOs on enrolling and delivering services to Medicare beneficiaries with dementia. The Commission conducted detailed interviews with professionals at eight diverse Medicare+Choice organizations. Their report provides background information on health care decision-making law and the Medicare program's laws and regulations, and focuses on survey findings in six key areas: marketing, enrollment, health assessments, health care delivery, advance directives, and…

  • Prescription Drug Trends: A Chartbook

    Report

    Prescription Drug Trends - A Chartbook, an analysis by the Kaiser Family Foundation and the Sonderegger Research Center, University of Wisconsin-Madison, provides information about trends in prescription drug coverage, spending, prices, use, and industry structure. Although overall coverage for prescription drugs has increased over the last decade, about a quarter of the nonelderly and a third of Medicare beneficiaries have no drug coverage. Spending for prescriptions is one of the fastest growing components of health…

  • Medicare Restructuring: The FEHBP Model – Report

    Report

    Medicare Restructuring: The FEHBP Model Executive Summary As policymakers consider measures to assure the long-range solvency of Medicare, one option that has received increasing attention is a "premium support" system. Under such a system beneficiaries would choose between the original Medicare fee-for-service program and a variety of competing health plans. They would receive a fixed government contribution toward the plan of their choice and would pay any remaining costs themselves. Proponents of a premium support…

  • A Medicare Buy-In for the Near Elderly: Design Issues and Potential Effects on Coverage

    Report

    This report examines a Medicare-based approach to reducing the ranks of the uninsured that would permit early retirees between the ages of 62 and 65 to purchase coverage under Medicare. The paper begins with an overview of the challenges of insuring the near-elderly and explores the potential effects of a Medicare buy-in on coverage of this population. The authors conclude that, unless premiums for such coverage were low or tied to enrollees' income, this approach…

  • Prescription Drug Coverage for Medicare Beneficiaries: A Side-by-Side Comparison of Selected Proposals

    Report

    Updated, July 31, 2002 This document, prepared by Health Policy Alternatives, Inc., provides a side-by-side comparison of five major federal proposals to provide outpatient prescription drug coverage to Medicare beneficiaries, introduced as of July 31, 2002: H.R. 4954, The Medicare Modernization and Prescription Drug Act of 2002 (passed by the House of Representatives on June 28, 2002); H.R. 5019, The Medicare Rx Drug Benefit and Discount Act of 2002 (Rep. Rangel/House Democratic proposal); S. 2625,…

  • Medicare’s Disabled Beneficiaries: The Forgotten Population in the Debate Over Drug Benefits

    Report

    About 5 million Americans under age 65 qualify for Medicare coverage because they are totally and permanently disabled. They are more likely than the elderly to live in poverty, to be in poor health, and to experience difficulties living independently and performing basic daily tasks. A new study from The Commonwealth Fund and the Henry J. Kaiser Family Foundation, reports that the disabled have few options other than Medicaid for obtaining prescription coverage. In ,…