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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  • Nursing Home Staffing Standards

    Report

    This policy brief describes the current federal staffing requirements and how states separately regulate staffing levels in nursing homes. It also presents data showing actual staffing levels in over half of this country's nursing homes exceed the levels that states and the federal government require. Report PDF Download

  • Prescription Drug Discount Cards: Current Programs and Issues

    Report

    As policymakers consider a range of approaches to providing prescription drug coverage to the Medicare population in today s tight budgetary environment, one proposal that has been put forth by the Bush Administration is that of a Medicare-endorsed prescription drug discount card program. This report describes the range of existing discount card programs run by both private sponsors and state governments and provides background information on the implications of this approach to assisting Medicare beneficiaries…

  • Family Circle/Kaiser Family Foundation National Survey on Health Care & Other Elder Care Issues

    Poll Finding

    As part of a joint project with Family Circle, this national survey examines the knowledge and experiences of 806 adults with a parent 65 and older in an effort to understand their role in helping their aging parents. The survey found that half check in on their parent with regular phone calls or visits, over four in ten visit or see their parent at least once a week, and more than a quarter help their…

  • The Role of PBMs in Managing Drug Costs: Implications for a Medicare Drug Benefit

    Other Post

    Extending a drug benefit to Medicare beneficiaries has been a highly publicized issue in recent months. To address the question of how to finance and administer such a benefit while controlling its cost, some have proposed using pharmacy benefit managers (PBMs)--companies that administer pharmaceutical benefits for health plans, HMOs, and employers while managing drug utilization and obtaining discounts from both retail pharmacies and manufacturers. Most recently, the Clinton Administration introduced a proposal for a Medicare…

  • Retiree Health Coverage: Recent Trends and Employer Perspectives on Future Benefits

    Report

    The report, based on an analysis of Hewitt Associates' client database, presents new trend data on the prevalence of retiree health coverage sponsored by large employers and finds a continued erosion of retiree health benefits. The report also includes findings from a new survey assessing how large employers might change their retiree health programs in the future, and on their reaction to the Administration's proposal to add a prescription drug benefit to Medicare. The Hewitt…

  • The Burden of Out-of-Pocket Health Spending Among Older Versus Younger Adults: Analysis from the Consumer Expenditure Survey, 1998-2003

    Issue Brief

    UPDATED: An updated version of this analysis is now available online. Recent policy debate has focused on the issue of rising health care costs and whether it might be possible to control costs by requiring consumers to pay a larger share of their health care costs out of pocket. While most of the policy discussion has focused on people of working age, rising health care costs and the burden of out-of-pocket spending also affects seniors,…

  • Access To Health Care:

    Report

    Promises and Prospects For Low-Income Americans This book explores critical issues affecting access to health care for low-income Americans by assessing the importance of expansions of health coverage for the poor, the emerging challenges providers who serve low-income and uninsured populations face in a rapidly evolving health care delivery system, and the effects of these changes on particularly vulnerable populations. Articles include: IntroductionMarsha Lillie-Blanton, Rose Marie Martinez, Barbara Lyons, Diane Rowland A Review Of The…

  • Dementia and Medicare Managed Care: A Growing Challenge for Health Plans

    Report

    The American Bar Association Commission on Legal Problems of the Elderly explored the views of Medicare HMOs on enrolling and delivering services to Medicare beneficiaries with dementia. The Commission conducted detailed interviews with professionals at eight diverse Medicare+Choice organizations. Their report provides background information on health care decision-making law and the Medicare program's laws and regulations, and focuses on survey findings in six key areas: marketing, enrollment, health assessments, health care delivery, advance directives, and…

  • Prescription Drug Trends: A Chartbook

    Report

    Prescription Drug Trends - A Chartbook, an analysis by the Kaiser Family Foundation and the Sonderegger Research Center, University of Wisconsin-Madison, provides information about trends in prescription drug coverage, spending, prices, use, and industry structure. Although overall coverage for prescription drugs has increased over the last decade, about a quarter of the nonelderly and a third of Medicare beneficiaries have no drug coverage. Spending for prescriptions is one of the fastest growing components of health…

  • Medicare Restructuring: The FEHBP Model – Report

    Report

    Medicare Restructuring: The FEHBP Model Executive Summary As policymakers consider measures to assure the long-range solvency of Medicare, one option that has received increasing attention is a "premium support" system. Under such a system beneficiaries would choose between the original Medicare fee-for-service program and a variety of competing health plans. They would receive a fixed government contribution toward the plan of their choice and would pay any remaining costs themselves. Proponents of a premium support…