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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  • Health Care and the 2004 Elections: Long Term Care

    Issue Brief

    Long Term Care Download a printable .pdf of Health Care and the 2004 Elections: Long Term Care. IssueBackgroundOptions for Addressing Long Term Care NeedsAssessing Candidate Positions Issue Millions of elderly and disabled Americans need long-term care services and supports. The aging of the population in the United States over the next several decades is expected to increase the demand for long-term care services. The number of elderly persons in the United States is projected to…

  • Medicare: The Basics, A Public Dialogue on Health Care: The Future of Medicare

    Other Post

    Medicare: The Basics Part Two A Henry J. Kaiser Family Foundation Report Coverage Under Managed Care Plans and Other Options The vast majority of Medicare beneficiaries have their health care bills paid directly by Medicare's traditional fee-for-service program. The rest-nearly 6 million people-are covered under managed care plans, mostly HMOs, which contract with Medicare. Since the mid-1980s, a growing number of beneficiaries have elected to receive the benefits covered by Medicare Parts A and B…

  • Nursing Home Care Quality:  Twenty Years After the Omnibus Budget Reconciliation Act of 1987

    Report

    Nursing Home Care Quality: Twenty Years After the Omnibus Budget Reconciliation Act of 1987 To mark the 20th anniversary of the passage of landmark federal legislation to improve the quality of nursing home care, the Omnibus Budget Reconciliation Act of 1987 (known as OBRA '87), this report explains the key provisions of OBRA ’87 related to nursing home care and examines the progress and problems in quality assurance in nursing homes over the past twenty…

  • Medicare Part D 2008 Data Spotlight: Ten Most Common Brand-Name Drugs

    Issue Brief

    This Medicare Part D Data Spotlight examines the variation in 2008 Part D plan coverage, cost sharing and utilization management tools for the 10 prescriptions most commonly used by Medicare beneficiaries, including treatments for cholesterol, cardiovascular health, osteoporosis, dementia, gastrointestinal reflux and ulcers. It looks at data from the 47 stand-alone prescription drug plans available nationwide in 2008. This data spotlight is one in a series analyzing key aspects of the 2008 Medicare Part D…

  • Medicare Part D 2008 Data Spotlight: Low-Income Subsidy Plan Availability

    Issue Brief

    This Medicare Part D Data Spotlight focuses on the availability of drug plans for beneficiaries receiving the Part D low-income subsidy in 2008 and changes since 2006. It looks at data from the 47 stand-alone prescription drug plans available nationwide in 2008. This is one in a series analyzing key aspects of the 2008 Medicare Part D prescription drug plan choices. The analysis was conducted jointed by Jack Hoadley of Georgetown University, Elizabeth Hargrave of NORC…

  • Medicare Prescription Drug Plans in 2008 and Key Changes Since 2006: Summary of Findings

    Issue Brief

    This synthesis of key findings from analysis presented in a series of eight Medicare Part D 2008 Data Spotlights describes key features of stand-alone prescription drug plans offered in 2008 and trends since 2006. The synthesis covers a range of topics, including premiums, the coverage gap, benefit design, cost sharing, specialty tiers, formularies, utilization management, the top 10 brand-name prescription drugs, and the availability of low-income subsidy plans. The analysis was conducted jointed by Jack…

  • Prescription Drug Coverage for Medicare Beneficiaries: A Side-by-Side Comparison of Selected Proposals

    Report

    This updated document, prepared by Health Policy Alternatives, Inc., provides a side-by-side comparison of the House and Senate Medicare proposals, as passed on June 27, 2003. The side-by-side describes key provisions of H.R. 1, The Medicare Prescription Drug and Modernization Act of 2003, and S. 1, The Prescription Drug and Medicare Improvement Act of 2003. This updated document, which includes CBO's recent estimates of the costs of each bill and additional detail on payments to…

  • 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