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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.

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+Choice Withdrawals: Understanding Key Factors

    Report

    To help understand why M+C plans have exited or limited their participation in the M+C program in recent years, this report presents an empirical analysis of the factors associated with plan withdrawals between 1999 and 2001. This analysis explores factors such as M+C payment levels, local market characteristics, and individual health plan characteristics to help predict plan withdrawals and draw inferences about the types of plans and markets that have been most adversely affected. Report

  • Selected Findings on Knowledge and Understanding of the New Medicare Rx Drug Program — January/February 2004 Kaiser Health Poll Report Survey

    Poll Finding

    Seniors are confused about the Medicare prescription drug law. Selected findings from the January/February 2004 Kaiser Health Poll Report survey show that while about two-thirds of seniors report following the debate closely, just 15% say they understand the new prescription drug law very well and seven in 10 don’t know that it passed and was signed into law. Survey Toplines Chartpack News Release Statement by Drew Altman, President and CEO, Kaiser Family Foundation on the…

  • Benefit improvements for low-income Medicare beneficiaries

    Report

    Benefit Improvements for Low-Income Medicare Beneficiaries The Kaiser Family Foundation has prepared a summary showing how the House-passed Children’s Health and Medicare Protection (CHAMP) Act legislation would change current law regarding assistance for low-income Medicare beneficiaries. The summary describes proposed changes to current programs that provide assistance to low-income Medicare beneficiaries, including the Medicare Savings Program and the Medicare Part D Low-Income Subsidy (LIS) Program. The summary reviews how the CHAMP Act would modify each…

  • The New Medicare Rx Benefit:  Challenges for Maintaining Access to Prescription Drugs

    Other Post

    The New Medicare Rx Benefit: Challenges for Maintaining Access to Prescription Drugs With the launch of the new Medicare Part D prescription drug benefit less than 18 months away, and growing interest in beneficiaries’ access to medications in the future, the Kaiser Family Foundation is pleased to release two new publications that examine issues concerning access to medications raised by the implementation of the new Part D Medicare prescription drug benefit. The New Medicare Drug…

  • Comparison of Medicare Provisions in Recent Bills and Proposals to Repeal and Replace the Affordable Care Act

    Issue Brief

    Repealing and replacing the Affordable Care Act is a top priority of the Trump Administration and the Republican leadership, which could have implications for the Medicare program. This brief provides a side-by-side comparison of the Medicare-related provisions in six bills and proposals that would repeal the ACA, excluding proposals that would not directly affect Medicare.

  • 10 Essential Facts About Medicare’s Financial Outlook

    Issue Brief

    Medicare, the nation’s federal health insurance program for 57 million people age 65 and over and younger people with disabilities, often plays a major role in federal health policy and budget discussions. Medicare is likely to be back on the federal policy agenda as Congress debates repealing and replacing the ACA, and also if policymakers turn their attention to reducing entitlement spending as part of efforts to reduce the growing federal budget deficit and debt.…

  • Medicaid’s Role for Medicare Beneficiaries

    Issue Brief

    This brief outlines Medicaid's role for Medicare beneficiaries. It describes the role that Medicaid plays for 10 million Medicare beneficiaries to help inform upcoming debates about proposals to restructure Medicaid financing in ways that could reduce federal funding.

  • Medicare Advantage Plan Switching: Exception or Norm?

    Issue Brief

    The Medicare open enrollment period allows enrollees to compare plans, stick with their current plan, switch to another plan, or shift to traditional Medicare. This analysis examines the extent to which Medicare Advantage enrollees change plans when given the opportunity. It also analyzes the variation in the rate of plan switching by enrollee and plan characteristics and whether people who voluntarily switch plans tend to move to plans with lower premiums, lower out-of-pocket limits, or…

  • How Much Has Medicare Spent on the EpiPen Since 2007?

    Issue Brief

    This data note examines the effects of rising EpiPen prices on Medicare and beneficiaries. We analyze EpiPen spending, in the aggregate and per user, in Medicare Part D between 2007 (the year after the Part D drug benefit took effect, and the year Mylan acquired the product) and 2014 (the most recent year of data available).