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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  • Living Close to the Edge: Financial Challenges and Tradeoffs for People on Medicare

    Report

    As Congress and other policymakers weigh potentially major changes to the Medicare program as part of the deficit-reduction debate, this Kaiser Family Foundation report highlights the role Medicare now plays in the lives of beneficiaries and the challenges many face in paying for their health care and other living expenses on a fixed budget. Based on detailed profiles of 16 Medicare families, the report examines beneficiaries' incomes, retirement savings and routine expenses, including health care…

  • Seniors' Knowledge and Experience With Medicare's Open Enrollment Period and Choosing a Plan: Key Findings from the Kaiser Family Foundation 2012 National Survey of Seniors

    Issue Brief

    These key findings from the Foundation's 2012 National Survey of Seniors relate to seniors’ knowledge and experience with Medicare’s open enrollment period and choosing a plan. The survey finds one in four seniors say they are unaware of this annual opportunity to review and change their Medicare coverage, with even larger shares who say they are unaware of Medicare’s open enrollment period among blacks and Hispanics and those seniors in fair or poor health, with…

  • The Transition of Dual Eligibles to Medicare Part D Prescription Drug Coverage: State Actions During Implementation

    Report

    This 50-state survey of Medicaid officials assesses states’ early experience relating to the transition of low-income seniors and people with disabilities enrolled in both Medicaid and Medicare (dual eligibles) to the Medicare Part D drug benefit. Conducted by Health Management Associates, the survey covers the types of problems observed by states during the transition of dual eligibles to the Medicare drug benefit, state actions to correct problems and ensure temporary coverage, and specific data on…

  • An In-Depth Examination of Formularies and Other Features of Medicare Drug Plans

    Report

    This study of Medicare Part D plans offered in 2006 examines formularies, drug costs and utilization management tools in drug plans offered by 14 national and near-national organizations. Collectively, these organizations account for 1,222 of the 1,429 Part D plans available to Medicare beneficiaries. The analysis finds that Medicare’s new, private, stand-alone drug plans vary significantly in terms of covered drugs, out-of-pocket costs for specific medications and restrictions placed on the use of certain drugs. The…

  • Beneficiary Challenges in Using the Medicare Part D Appeals Process To Obtain Medically Necessary Drugs

    Issue Brief

    This paper describes the various steps of the Medicare Part D appeals process for obtaining necessary drugs not on a plan’s formulary. Using case reports collected from a network of beneficiary advocates, it illustrates the challenges and problems some beneficiaries encountered when navigating this aspect of the drug benefit. The paper concludes with a discussion of potential policy options including the implications of establishing an exceptions and appeals process that is uniform in paperwork and…

  • Retiree Health Benefits Now and In the Future – Chartpack

    Report

    This chartpack (charts used at the briefing releasing this survey), from the survey conducted by the Kaiser Family Foundation and Hewitt Associates between June and September 2003, provides detailed information on retiree health programs offered by large private-sector employers. The data in this survey reflect the responses of 408 large firms (private-sector employers with 1,000 or more workers) and provides information on eligibility, benefits, premiums, and total cost in 2003, and offers insights as to…

  • Medicare Advantage in 2008

    Issue Brief

    Medicare Advantage plans enrolled a record 9.8 million beneficiaries, more than one in five of the nation’s 44 million people on Medicare as of April 2008. That represents an increase of more than 800,000 beneficiaries in just four months, continuing a period of unprecedented growth for private plans in Medicare since 2003. This issue brief, prepared for the Kaiser Family Foundation by Marsha Gold of Mathematica Policy Research, Inc., analyzes recent developments in the Medicare…

  • Medicare Now and in the Future

    Issue Brief

    Download PDF Issue Medicare is a valuable source of health insurance for nearly 45 million Americans – mainly seniors ages 65 and older, but also 7 million younger adults with permanent disabilities.  Before Medicare was signed into law in 1965, about half of all seniors lacked hospital insurance.  Today, virtually all people ages 65 and over are covered by Medicare.  Medicare is a popular program, but faces a number of issues and challenges in the…