Medicare

New & Noteworthy

What to Know About Medicare Coverage of Telehealth

Congress has repeatedly extended pandemic-era flexibilities around Medicare coverage of telehealth, but most such flexibilities remain temporary. This brief answers key questions about the current scope of Medicare telehealth coverage, including both temporary and permanent changes adopted through legislation and regulation, and future policy considerations.

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.

Related: FAQs on Medicare Financing and Trust Fund Solvency

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  • New Trump Administration Proposals Would Further Limit Gender Affirming Care for Young People by Restricting Providers and Reducing Coverage

    Issue Brief

    This brief examines two proposed federal rules that would further restrict youth access to gender affirming care. One rule would change the hospital Conditions of Participation (CoPs) which would prohibit most Medicare and Medicaid enrolled hospitals from providing certain types of gender affirming medical care for young people and the other would prohibit federal Medicaid or CHIP funds from covering this care. The rules have a 60-day comment period, do no take immediate effect, and are expected to face litigation, if finalized.

  • Medicare Part D at Ten Years: The 2015 Marketplace and Key Trends, 2006-2015

    Report

    Since 2006, Medicare beneficiaries have had access through Medicare Part D to prescription drug coverage offered by private plans, either stand-alone prescription drug plans (PDPs) or Medicare Advantage prescription drug plans (MA-PD plans). Now in its tenth year, Part D has evolved due to changes in the private plan marketplace and the laws and regulations that govern the program. This report presents findings from an analysis of the Medicare Part D marketplace in 2015 and changes in features of the drug benefit offered by Part D plans since 2006.

  • Seniors and Income Inequality: How Things Get Worse With Age

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman discusses why seniors need to be included in the national discussion on income inequality, especially as proposals to change Medicare and Social Security are considered. All previous columns by Drew Altman are available.

  • A Gender Gap in Economic Security for Seniors

    From Drew Altman

    Following up on an earlier column for The Wall Street Journal's Think Tank on seniors and poverty, Drew Altman looks at why older women will be more at risk of economic insecurity than men in the future.

  • Medicare Advantage Enrollment Continues to Climb, but Financial Protections for Enrollees Are Eroding 

    News Release

    Enrollment in Medicare Advantage continues to climb steadily as spending reductions enacted in the Affordable Care Act reduce historical overpayments to the private plans, according to a new analysis by the Kaiser Family Foundation. But limits on out-of-pocket spending for Medicare-covered services are rising, providing less protection for enrollees with relatively high health care expenses.

  • Amid Merger Talk, a Look at Health Insurers’ Medicare Business

    News Release

    With recent news about possible health insurance company mergers, Drew Altman looks beyond the impact on Wall Street to how mergers could affect Medicare beneficiaries in his latest column for The Wall Street Journal's Think Tank. All previous columns by Drew Altman are available.