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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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  • Voices of Beneficiaries: Attitudes Toward Medicare Part D Open Enrollment for 2008

    Other Post

    This report focuses on the recent experiences of a group of 35 Medicare beneficiaries in the early years of the Medicare prescription drug benefit, including a number who were enrolled in a Medicare Part D drug plan in 2007. It looks at their attitudes about the open enrollment season for 2008, and their interest related to switching to a new Part D plan for 2008. It finds that most enrollees do not intend to reexamine…

  • Reports Analyze Cost and Coverage of People Eligible for Both Medicaid and Medicare and Options for Reforming Financing of Their Care

    Issue Brief

    These issue briefs examine coverage of the nearly 9 million "dual eligibles," the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid. The reports explore the national and state impacts of shifting the financing of selected services for dual eligibles from Medicaid to Medicare, and provide state-level Medicaid spending and enrollment data related to this population. The policy options studied could collectively provide tens of billions of dollars in annual…

  • Rethinking Medicaid’s Financing Role for Medicare Enrollees

    Issue Brief

    This issue brief examines coverage of the nearly 9 million "dual eligible" beneficiaries, the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid. It explores the national and state impacts of shifting the financing of selected services for dual eligibles from Medicaid to Medicare, including having the federal government pick up the full cost of Medicare premiums, cost-sharing and gaps in Medicare-covered services and long-term care services for this population.…

  • Chartpack: Kaiser Health Tracking Poll — April 2009

    Poll Finding

    This document contains the chartpack from the April Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted April 2 through April 8, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (902) and cell phone (301, including 98 who had no landline telephone) were carried out in English and Spanish. The margin of…

  • Toplines: Kaiser Health Tracking Poll — April 2009

    Poll Finding

    This document contains the toplines from the April Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted April 2 through April 8, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (902) and cell phone (301, including 98 who had no landline telephone) were carried out in English and Spanish. The margin of…

  • The Obama Administration’s 2010 Call Letter for Medicare Advantage and Prescription Drug Plans: Implications for Beneficiaries

    Issue Brief

    On March 30, 2009, the Centers for Medicare & Medicaid Services issued the 2010 “call letter,” which functions as a request for proposals to private health insurers and organizations that want to sponsor Medicare Advantage Plans or Medicare Prescription Drug Plans. This issue brief reviews the call letter — the first issued by the Obama Administration — and examines the implications for beneficiaries of some of the proposed changes, including its emphasis on accountability of health plan sponsors, promoting…

  • Medicare Part D 2009 Data Spotlight: Specialty Tiers

    Issue Brief

    Most Medicare Part D prescription drug plans use tiers with different cost-sharing amounts for generic, preferred, and non-preferred drugs, and also include an additional “specialty” tier for very high cost and unique drugs. This 2009 Part D Data Spotlight examines use of the specialty tier, including the numbers and kinds of drugs included on specialty tiers, what beneficiaries pay for those drugs, and trends over time. The spotlight is one in a series analyzing key…

  • Explaining Health Reform: Medicare and the New Independent Payment Advisory Board

    Issue Brief

    This brief describes how the new board created under the 2010 health reform law is expected to limit the growth in Medicare spending over time. Starting in 2014, if projected per capita Medicare spending exceeds targets set in the law, the board must recommend ways to reduce Medicare spending, while maintaining quality and access to care for beneficiaries. The board’s recommendations automatically take effect the next year unless Congress adopts an alternative plan to achieve…

  • Medicare Part D 2010 Data Spotlight: The Coverage Gap

    Report

    This data spotlight examines the coverage gap, or "doughnut hole," in Medicare stand-alone drug plans available in 2010. While in the gap in coverage, Part D enrollees (other than those receiving low-income subsidies) are required to pay 100 percent of total drug costs until they reach the catastrophic coverage level. In 2010, nearly all the private stand-alone drug plans have a coverage gap, though a small share do provide some help to beneficiaries in the…

  • Explaining Health Reform: Key Changes in the Medicare Advantage Program

    Issue Brief

    This brief examines the changes in the 2010 health reform law affecting the Medicare Advantage program, which gives beneficiaries the option of enrolling in private insurance plans for their Medicare benefits, instead of the traditional fee-for-service program. The reform law will gradually reduce Medicare payments to these plans to bring the average payment closer to the costs of traditional fee-for-service Medicare, while rewarding plans with high-quality ratings. The brief also describes new benefit requirements for…