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.

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. 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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  • What Do We Know About Health Care Access and Quality in Medicare Advantage Versus the Traditional Medicare Program?

    Report

    As the number of Medicare Advantage enrollees continues to climb, there is growing interest in understanding how the care provided to Medicare beneficiaries in Medicare Advantage plans differs from the care received by beneficiaries in traditional Medicare. This literature review of more than 40 studies synthesizes the evidence to date comparing access and quality for beneficiaries in Medicare Advantage plans and traditional Medicare.

  • 3 Takeaways From the Medicare Trustees Report

    From Drew Altman

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman dives into this week’s release of the Social Security and Medicare Trustees Report to discuss the good news that may have been missed.

  • Paying a Visit to the Doctor: Current Financial Protections for Medicare Patients When Receiving Physician Services

    Issue Brief

    This issue brief explains provisions in current law that shield beneficiaries from unexpected and confusing charges when they see physicians and practitioners—namely, the participating provider program, limitation on balance billing, and conditions on private contracting for doctors who opt out of Medicare or join “concierge” practices. It also analyzes the implications of modifying these provisions for beneficiaries, providers, and the Medicare program.

  • Medicare 101 Tutorial

    Interactive

    This tutorial was produced for kaiserEDU.org, a Kaiser Family Foundation website that ceased production in September 2013. The kaiserEDU.org tutorials are no longer being updated but have been made available on kff.org due to demand by professors who are using the tutorials in class assignments. You may search for other tutorials to view on kff.org. To download this or other tutorials, visit the tutorials archive page.  Slides are available for download using the “Download Slides” link within the…

  • Medicare Advantage: The Role of Private Health Plans in Medicare Tutorial

    Interactive

    This tutorial was produced for kaiserEDU.org, a Kaiser Family Foundation website that ceased production in September 2013. The kaiserEDU.org tutorials are no longer being updated but have been made available on kff.org due to demand by professors who are using the tutorials in class assignments. You may search for other tutorials to view on kff.org. To download this or other tutorials, visit the tutorials archive page.  Slides are available for download using the “Download Slides” link within the…

  • Retiree Health Benefits At the Crossroads

    Report

    This issue brief reviews recent trends and developments in employer-sponsored retiree health coverage and examines the impact of recent legislation, such as the Medicare drug benefit and the Affordable Care Act (ACA) on retiree health coverage. The report describes leading strategies employers have been pursuing or considering to limit costs for retiree health benefits. In addition, the report considers the potential implications of proposals aimed at reducing federal spending for retiree health coverage and costs.

  • Medicare Advantage 2014 Spotlight: Enrollment Market Update

    Issue Brief

    This Data Spotlight provides an overview of Medicare Advantage enrollment patterns in March 2014, and examines variations by plan type, state, and firm. It also analyzes trends in premiums paid by beneficiaries enrolled in Medicare Advantage plans and describes the changes in limits on out-of-pocket expenses and prescription drug coverage in the Part D “donut hole” provided by the plans in 2014.

  • Independent Payment Advisory Board (IPAB) Process: A Timeline

    Feature

    IPAB Timeline Download Source Kaiser Family Foundation, “The Independent Payment Advisory Board: A New Approach to Controlling Medicare Spending,” 2011, https://www.kff.org/health-reform/issue-brief/the-independent-payment-advisory-board-a-new/.