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.

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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  • Public vs. Private Health Insurance on Controlling Spending

    News Release

    In his latest column for The Wall Street Journal's Think Tank, Drew Altman analyzes whether public or private health insurance does a better job of controlling costs. All previous columns by Drew Altman are available online. 

  • Reading the Stars: Nursing Home Quality Star Ratings, Nationally and by State

    Issue Brief

    This issue brief presents national and state-level analysis of nursing homes based on the Five-Star Quality Rating System, recently updated by the Centers for Medicare and Medicaid Services (CMS) to help consumers compare nursing homes when selecting one for themselves or their family members. The issue brief finds that more than one-third (36%) of the nation’s 15,500 nursing homes certified by Medicare or Medicaid received relatively low ratings of 1 or 2 stars (out of…

  • How Much of the Medicare Spending Slowdown Can be Explained? Insights and Analysis from 2014

    Issue Brief

    This paper identifies and quantifies, to the extent possible, the factors that explain the gap between actual Medicare spending in 2014 and CBO's 2009 projections of what Medicare spending would be this year. The study synthesizes information from a variety of sources and presents new analysis to assess the extent to which lower-than-projected Medicare spending in 2014 can be explained by deliberate policy and program changes, unexpected trends, and other factors.

  • Visualizing Health Policy: Medicare Spending: A Look at Present, Short-Term and Long-Term Trends

    Other Post

    This Visualizing Health Policy infographic with the Journal of the American Medical Association (JAMA) provides an overview of Medicare spending trends in the present, short term and long term. In the long term, Medicare spending as a share of the economy is projected to grow, and Medicare is projected to lack sufficient funds to pay all hospital bills beginning in 2030.

  • 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. Medicare Advantage enrollment grew in virtually all states and reached 16.8 million beneficiaries as of March 2015, an increase of…

  • 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.

  • Visualizing Health Policy: Medicaid and Medicare at 50: Trends and Challenges

    Other Post

    These Visualizing Health Policy infographics commemorate the 50th anniversary of the Medicaid and Medicare programs. This infographic provides details about the reach and demographics of the programs, as well as the Federal and total US health-care spending associated with them. This infographic illustrates trends and challenges going forward. Together, Medicaid and Medicare provide health insurance coverage for more than 3 in 10 Americans. Medicaid serves a notable share of children, nursing home residents, and Americans younger than 65…

  • New Article and Infographics in JAMA Examine Medicaid and Medicare at 50 Years

    News Release

    The July 28 special issue of the Journal of the American Medical Association (JAMA) includes an article written by Kaiser Family Foundation President and CEO Drew Altman and former U.S. Senate Majority Leader William H. Frist, MD, and two infographics from the Foundation that examine the past, present, and future of Medicaid and Medicare. Medicare and Medicaid at 50 Years: Perspectives of Beneficiaries, Health Care Professionals and Institutions, and Policy Makers examines the roles the two programs…

  • Survey Finds Many Primary Care Physicians Have Negative Views of the Use of Quality Metrics and Penalties for Unnecessary Hospital Readmissions 

    News Release

    Primary Care Providers View Health IT as Improving Quality, But Tilt Negatively on ACOs Half of the nation's primary care physicians view the increased use of quality-of-care metrics and financial penalties for unnecessary hospitalizations as potentially troubling for patient care, according to a new survey from The Commonwealth Fund and the Kaiser Family Foundation. Fifty percent of primary care physicians say the increased use of quality metrics to assess provider performance is having a negative…

  • Dual Eligible Demonstrations: The Beneficiary Perspective

    Issue Brief

    This issue brief provides insights about initial implementation of the financial alignment demonstrations from the perspective of dual eligible beneficiaries in Massachusetts, Ohio, and Virginia, based on 12 individual interviews conducted in early 2015. Profiles of six beneficiaries are presented to illustrate representative program experiences, along with key findings from across all of the interviews.