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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  • Reaching for the Stars: Quality Ratings of Medicare Advantage Plans, 2011

    Issue Brief

    New: Medicare Advantage Plan Star Ratings and Bonus Payments in 2012 In 2012, Medicare Advantage plans will be awarded additional payments based on their quality ratings as a result of the 2010 health reform law. The Centers for Medicare and Medicaid Services has proposed a demonstration that would modify the quality-based payments for plans, providing additional payments for 2012 to 2014. This policy brief by the Kaiser Family Foundation examines the quality ratings of private…

  • The Role of Medicare and Beneficiaries in the Deficit-Reduction Debate

    Event Date:
    Event

    This Kaiser Family Foundation briefing examined how Medicare reform options now under consideration might work and their implications for beneficiaries and taxpayers. As context for understanding the potential effects of reforms, the briefing looked at the current and projected income and assets of people on Medicare, out-of pocket health care spending and the ability of Medicare beneficiaries to absorb rising costs. The Foundation also released a new report and video profiling Medicare families and the…

  • Managing Costs and Improving Care: Team-based Care of the Chronically Ill

    Event Date:
    Event

    Treating those with multiple chronic conditions, including the elderly and disabled populations, accounts for 30 percent of total U.S. health care spending. Half of this amount is spent by Medicare and Medicaid on behalf of beneficiaries eligible for both programs. This briefing, cosponsored by the Alliance for Health Reform and The Commonwealth Fund, looked at ways to improve the quality of care for the chronically ill while reducing the growth in spending for their care.…

  • The Medicare Program: Panorama General De Medicare

    Fact Sheet

    Que Es El Medicare Y Como Se Financia? Medicare es un programa de seguro medico nacional que atiende a 39 millones de ancianos y discapacitados. Antes de la existencia del Medicare, menos de la mitad de todos los norteamericanos de edad avanzada contaban con un seguro medico. Hoy en dia, practicamente todos los adultos de 65 anos de edad mayores se encuentran asegurados bajo Medicare. Medicare cubre a 34 millones de beneficiarios ancianos y a…

  • Disparities in Women’s Health

    Other Post

    Disparities in Women's Health Disparities in health and health care continue to burden women, particularly affecting women of color or those who are poor. To shed more light on the factors contributing to inequalities in health and access to care for women, the Kaiser Family Foundation provided support for the newest issue of the Journal of the American Medical Women's Association (JAMWA) Disparities in Women's Health. This special issue features an editorial by Surgeon General…

  • Medicare Beneficiaries and Their Assets: Implications for Low-Income Programs

    Report

    This report, prepared by Marilyn Moon of The Urban Institute and Robert Friedland and Lee Shirey of Georgetown University's Center on an Aging Society, reviews the income and assets of the current Medicare population, provides an overview of asset tests used to determine eligibility for programs assisting low-income Medicare beneficiaries, and considers how alternative policy options would affect eligibility for these programs. The authors find that beneficiaries with low incomes tend to have minimal assets.…

  • Prescription Drug Discount Card Programs: Implications for Medicare Beneficiaries

    Report

    This testimony was delivered by Tricia Neuman, a vice president of the Kaiser Family Foundation, at a Senate Finance Committee hearing on the Bush Administration's Proposals for Medicare Modernization. The statement, which draws upon a report prepared for the Foundation by Health Policy Alternatives, Inc., provides an overview of existing prescription drug discount card programs, describes some of the features of the Administration's recently released proposal for a Medicare-endorsed discount card program, and raises some…

  • Medicare+Choice in California: Lessons and Insights

    Report

    Thirty-five percent of all California Medicare beneficiaries are enrolled in a M+C plan, far in excess of the 14 percent rate nationwide. This report seeks to identify what lessons for the nation can be drawn from the California M+C experience, as Congress debates the implications of major withdrawals from the M+C program and potential policy changes aimed at reversing this trend. The report is based largely on analysis of M+C data on plan participation, withdrawals,…

  • Paying for Choice: The Cost Implications of Health Plan Options For People on Medicare

    Report

    This report illustrates the financial stakes for Medicare beneficiaries when making choices about supplemental insurance coverage, by examining how much people on Medicare could spend out-of-pocket including premiums and other cost-sharing requirements under different supplemental insurance options. To assess the cost implications of choosing between different Medigap and Medicare+Choice insurance options, the research team estimated the range in health care expenditures associated with three prototypical beneficiaries (a 50 year-old man with disabilities, a relatively healthy…

  • Medicare Prescription Drugs Through Private Drug-Only Plans: A Discussion with Actuaries

    Report

    Central to the current debate over Medicare prescription drug coverage is the role of private insurance plans in providing drug benefits to Medicare beneficiaries. This report offers views from health actuaries knowledgeable about the Medicare program and the prescription drug debate on key issues that emerge for potential plan sponsors, such as insurers and PBMs, in providing prescription drug benefits to Medicare beneficiaries through private, drug-only plans. The views of the actuaries were obtained through…