Medicare

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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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  • Medicare Part D Issue Briefs

    Issue Brief

    These issue briefs, prepared by the Centers for Medicare Advocacy, Inc., provide information about how the Medicare drug benefit will affect beneficiaries. The briefs address issues related to dual eligibles, residents of nursing home and assisted living facilities, and the Part D exceptions and appeals processes. Medicare Part D: Issues for Dual Eligibles on the Eve of Implementation Medicare Prescription Drug Coverage for Residents of Nursing Homes and Assisted Living Facilities: Special Problems and Concerns…

  • Insights on Transitioning From Medicaid to the New Medicare Prescription Drug Benefit

    Report

    The Kaiser Commission on Medicaid and the Uninsured convened a focus group of state Medicaid officials in November 2005 to discuss the impact of the new Medicare drug program on states and Medicaid enrollees. State insights on the transition of dual eligibles and some beneficiary experiences are discussed in new material and an audio briefing. Podcast: December 19, 2005 Conference Call Briefing (Downloadable Audio File) Presentations from the December 19, 2005 Conference Call Briefing (.pdf)…

  • Study Finds Advertising By Insurers Favors Medicare Advantage Over Stand-Alone Drug Plans

    Issue Brief

    As the marketing period for 2009 Medicare plans nears, the Kaiser Family Foundation Kaiser Family Foundation issued a report analyzing the content and frequency of television, print and radio advertisement for private Medicare plans that ran nationally or in one of three local media markets (Miami/Fort Lauderdale, Fla.; Phoenix, Ariz.; and Greensboro, N.C) during the marketing and enrollment period for 2008 plan offerings. The study finds that insurers last year placed three times more advertisements…

  • Pulling it Together from Drew Altman: Multiple Agendas for Controlling Health Care Costs

    Perspective

    In what would be a domestic policy trifecta, we may be headed for interconnected big debates about economic recovery, entitlement programs and health reform. A core issue in the entitlement and health reform debates is the problem of rising health care costs. President Obama, now apparently fully briefed on the economic, budget and health reform realities he faces, is talking conspicuously about hard choices that may lie ahead. In a short period of time the…

  • Explaining Health Care Reform: How Might a Reform Plan Be Financed?

    Issue Brief

    One of the key challenges in enacting a health care reform plan is how to finance it among government, employers, and individuals. Of particular concern to policymakers is what effect a health reform plan would have on government spending and the federal budget. President Obama and Congressional leaders have said that any health reform plan should not add to the budget deficit over a 10 year period. This brief explains the likely sources of added…

  • What’s in the Stars? Quality Ratings of Medicare Advantage Plans, 2010

    Issue Brief

    NEW: Foundation brief looks at implications of 2011 quality ratings for Medicare Advantage plans. The Centers for Medicare and Medicaid Services (CMS) rates the relative quality of the private plans that are offered to Medicare beneficiaries through the Medicare Advantage program as a way of aiding beneficiaries who are considering enrolling in such a private plan. CMS rates Medicare Advantage plans on a one to five-star scale, with five stars representing the highest quality. This…

  • 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…

  • Transforming Medicare into a Premium Support System: Implications for Beneficiary Premiums

    Report

    This study illustrates why geography would matter for Medicare beneficiaries under a premium support system that relies on a competitive bidding process envisioned under several key Medicare reform proposals. It examines potential changes in the premiums paid by Medicare beneficiaries under a payment approach that caps federal contributions per beneficiary based on the cost of the second lowest-bidding private plan or traditional Medicare, whichever is lower in their area. Under this approach, beneficiaries can choose…

  • Medicare Beneficiaries and HMOs: Highlights of Los Angeles and New York City Medicare HMO Markets

    Fact Sheet

    A growing number of Medicare beneficiaries are enrolling in Medicare HMOs as an alternative to the traditional Medicare program. However, Medicare HMO enrollment has not grown uniformly in market areas across the country. Case studies conducted by researchers at Mathematica Policy Research, Inc. for The Kaiser Family Foundation describe the evolution of Medicare managed care in the two largest markets in the United States: Los Angeles County and New York City. The reports also discuss…

  • Medicare Restructuring: The FEHBP Model

    Other Post

    Executive Summary Part 2 How Well Does FEHBP work? FEHBP has been somewhat more successful than Medicare in controlling costs. However, recent trends indicate that FEHBP's competitive structure alone cannot guarantee cost control over the long term. Until recently, FEHBP experienced slightly lower growth in spending per enrollee than Medicare. Over the period 1987 to 1997, Medicare spending per beneficiary grew at an annual rate of 8.1 percent. FEHBP spending per enrollee grew at 7.1…