Medicare

NEW AND NOTEWORTHY

What to Know About Medicare Coverage of Telehealth

Congress has repeatedly extended pandemic-era flexibilities around Medicare coverage of telehealth, but most such flexibilities remain temporary. This brief answers key questions about the current scope of Medicare telehealth coverage, including both temporary and permanent changes adopted through legislation and regulation, and future policy considerations.

Changes to the Medicare Advantage Program Enhance Some Consumer Protections But Roll Back Others

CMS recently finalized policies as part of the 2027 Medicare Advantage final rule that both enhance consumer protections and roll back changes to the Medicare Advantage program that were intended to protect consumers. These changes have gotten less attention than payment issues and changes to the star ratings system, which also affect plan payments, but could have implications for Medicare beneficiaries.

Examining the Potential Impact of Medicare’s New WISeR Model

A federal initiative to establish new prior authorization requirements in traditional Medicare, called the Wasteful and Inappropriate Service Reduction (WISeR) model, is likely to have only modest impact in its first year.

State Profiles for Dual-Eligible Individuals

This data collection draws on Medicare and Medicaid administrative data to present national and state-level information on people who are covered by both Medicare and Medicaid, referred to as dual-eligible individuals (also known as dually-enrolled beneficiaries).

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. u003cbru003eu003cbru003eExplore 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.u003cbru003eu003cbru003eu003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022 data-type=u0022linku0022 data-id=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003eRelated:u003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003e FAQs on Medicare Financing and Trust Fund Solvencyu003c/au003eu003c/au003e

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  • The Public’s Health Care Agenda for the New Congress and Presidential Campaign, December 2006

    Poll Finding

    This Kaiser Family Foundation/Harvard School of Public Health National Survey looks at the public's priorities and views on health issues as a new Democratic majority takes the leadership of Congress and as the 2008 presidential campaign begins to take shape. It focuses, in particular, on differences and similarities among Democrats, Republicans, and those who identify themselves as Independents or something else. The poll, conducted November 9-19, 2006, by the Kaiser Family Foundation and the Harvard…

  • Health Affairs Article Examines Enrollment in Medicare Drug Plans As The Benefit Approaches Its Second Year

    Report

    Health Affairs Article Examines Enrollment in Medicare Drug Plans As The Benefit Approaches Its Second Year An article by Kaiser Family Foundation researchers published as a Health Affairs Web Exclusive provides a comprehensive look at the 2006 private Medicare drug plan enrollment as the enrollment period for 2007 begins. The article examines organization- and plan-level market share, as well as enrollment by type of plan, benefit design, and gap coverage. Health Affairs Web Exclusive (free…

  • Benefit Design and Formularies of Medicare Drug Plans: A Comparison of 2006 and 2007 Offerings

    Report

    This analysis provides a profile of the 2007 Medicare Part D stand-alone drug plans that are being offered to the program’s 43 million beneficiaries for 2007 and highlights some of the changes in plans between 2006 and 2007. It looks at premiums, covered drugs, the amount enrollees pay to fill a prescription, and other key features that would affect out-of-pocket costs and access to drugs for people with Medicare. The report describes the 1,875 stand-alone…

  • National Survey of Pharmacists 2006: Full Topline Results

    Poll Finding

    National Survey of Pharmacists 2006: Full Topline Results These toplines provide additional findings from a 2006 national survey of pharmacists on their views and experiences on a wide range of health care issues. Toplines (.pdf)

  • National Survey of Physicians 2006: Full Topline Results

    Poll Finding

    National Survey of Physicians 2006: Full Topline Results These toplines provide additional findings from a 2006 national survey of physicians on their views and experiences on a wide range of health care issues. Toplines (.pdf)

  • Additional Findings from the National Surveys of Doctors and Pharmacists

    Poll Finding

    Two Kaiser Family Foundation national surveys of doctors and pharmacists examine additional findings on their views and experiences on a wide range of health care issues. The topics covered in the surveys include views and experiences with medical errors and quality issues, use of health care information technology, prescription drug advertisements, views on Medicaid provisions, doctors' willingness to see Medicaid and Medicare patients, and physicians' views of conscience-clause provisions. The Kaiser Family Foundation National Survey…

  • Oversight and Enforcement of Medicare Part D Plan Requirements:  Federal Role and Responsibilities

    Issue Brief

    Oversight and Enforcement of Medicare Part D Plan Requirements: Federal Role and Responsibilities This Issue Brief was commissioned by the Kaiser Family Foundation to gain insights into legal advocates’ views of how federal authorities enforce compliance with requirements of the new Medicare Part D prescription drug benefit. The report was prepared by Toby Edelman of the Center for Medicare Advocacy, Inc. The views expressed in this report are those of the author and not necessarily…

  • 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…