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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  • How Much ‘Skin In The Game’ Do Medicare Beneficiaries Have? The Increasing Financial Burden of Health Care Spending, 1997-2003

    Issue Brief

    This study evaluated the changes in Medicare beneficiaries' health care spending between 1997 and 2003, and found beneficiaries spent a growing share of their income on health care. The results showed that median out-of-pocket health spending increased from 11.9% of income in 1997 to 15.5% in 2003, and about four in 10 beneficiaries spent at least one-fifth of their income on health care in 2003. Researchers using data from the Medicare Current Beneficiary Survey found…

  • Benefit improvements for low-income Medicare beneficiaries

    Report

    Benefit Improvements for Low-Income Medicare Beneficiaries The Kaiser Family Foundation has prepared a summary showing how the House-passed Children’s Health and Medicare Protection (CHAMP) Act legislation would change current law regarding assistance for low-income Medicare beneficiaries. The summary describes proposed changes to current programs that provide assistance to low-income Medicare beneficiaries, including the Medicare Savings Program and the Medicare Part D Low-Income Subsidy (LIS) Program. The summary reviews how the CHAMP Act would modify each…

  • 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,…

  • Medicare Prescription Drug Benefit Progress Report: Findings From A 2006 National Survey of Seniors

    Event Date:
    Event

    The share of seniors without drug coverage dropped significantly under Medicare’s new drug benefit, according to this August 2007 Health Affairs Web Exclusive article based on a Kaiser Family Foundation, Commonwealth Fund and Tufts-New England Medical Center survey of more than 16,000 seniors. Seniors with drug coverage from any source were less likely to face high monthly drug costs or to skip prescribed medications due to cost than seniors who remained without drug coverage. However,…

  • Learning From History: Deinstitutionalization of People with Mental Illness As Precursor to Long-Term Care Reform

    Report

    This report examines what policy lessons can be learned from the deinstitutionalization of people with mental illnesses and applied to potential long-term care reform for the elderly or those with significant disabilities. The study assesses the reforms that took place under deinstitutionalization, their impact and what mistakes were made. It also discusses the take-away lessons for long-term care policy, with a focus on planning, financing, living situations and the role of families, workplace issues, and…

  • The Role of State Pharmaceutical Assistance Programs in Serving Low-Income Medicare Beneficiaries Following the Implementation of Medicare Part D

    Issue Brief

    The Role of State Pharmaceutical Assistance Programs in Serving Low-Income Medicare Beneficiaries Following the Implementation of Medicare Part D Prior to January 1, 2006, State Pharmaceutical Assistance Programs helped to fill a critical gap in coverage for Medicare beneficiaries without prescription drug coverage, targeting resources to beneficiaries with relatively low incomes. With the inception of the Medicare prescription drug benefit, the role of SPAPs began to change. This policy brief examines the role of state…

  • Private Fee-For-Service Plans In Medicare: Rapid Growth and Future Implications

    Event

    Kaiser Family Foundation Vice President Patricia Neuman, Ph.D., testified May 2007 before the House Ways and Means Subcommittee on Health on the rapid growth of private fee-for-service plans in the Medicare program and its implications for seniors and people with disabilities. Dr. Neuman is director of the Foundation's Medicare Policy Project. Testimony (.pdf)

  • Perspectives on Medicare Part D and Dual Eligibles: Key Informants’ Views From Three States

    Report

    In 2006, low-income individuals receiving health coverage through both the Medicaid and Medicare programs, “dual eligibles,” experienced a change in their prescription drug benefit when their Medicaid prescription coverage was replaced by the Medicare prescription drug program known as Medicare Part D. This study provides information on the ongoing successes and challenges that dual eligibles faced in the first eight months of Part D and how different state approaches may affect dual eligibles’ ability to…