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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  • Medicare+Choice in California: Lessons and Insights

    Report

    Thirty-five percent of all California Medicare beneficiaries are enrolled in a M+C plan, far in excess of the 14 percent rate nationwide. This report seeks to identify what lessons for the nation can be drawn from the California M+C experience, as Congress debates the implications of major withdrawals from the M+C program and potential policy changes aimed at reversing this trend. The report is based largely on analysis of M+C data on plan participation, withdrawals,…

  • Paying for Choice: The Cost Implications of Health Plan Options For People on Medicare

    Report

    This report illustrates the financial stakes for Medicare beneficiaries when making choices about supplemental insurance coverage, by examining how much people on Medicare could spend out-of-pocket including premiums and other cost-sharing requirements under different supplemental insurance options. To assess the cost implications of choosing between different Medigap and Medicare+Choice insurance options, the research team estimated the range in health care expenditures associated with three prototypical beneficiaries (a 50 year-old man with disabilities, a relatively healthy…

  • Medicare Prescription Drugs Through Private Drug-Only Plans: A Discussion with Actuaries

    Report

    Central to the current debate over Medicare prescription drug coverage is the role of private insurance plans in providing drug benefits to Medicare beneficiaries. This report offers views from health actuaries knowledgeable about the Medicare program and the prescription drug debate on key issues that emerge for potential plan sponsors, such as insurers and PBMs, in providing prescription drug benefits to Medicare beneficiaries through private, drug-only plans. The views of the actuaries were obtained through…

  • Medicare Beneficiaries: A Population At Risk – Findings from the Kaiser/Commonwealth 1997 Survey of Medicare Beneficiaries – Report

    Report

    Medicare Beneficiaries: A Population at RiskFindings from the Kaiser/Commonwealth Fund 1997 Survey of Medicare Beneficiaries Cathy Schoen, Patricia Neuman, Michelle Kitchman, Karen Davis, and Diane RowlandDecember 1998 Table Of ContentsExecutive Summary Findings from the Kaiser/Commonwealth 1997 Survey of Medicare Beneficiaries Medicare Beneficiaries: Health Status and Income Health Insurance Coverage Satisfaction, Access, and Financial Burden: Variations by Income Prescription Drugs: Use and Cost Exposure Satisfaction, Access, and Financial Burden: Variations by Type of Insurance Coverage HMOs:…

  • Medicare and Medicaid for the Elderly and Disabled Poor

    Fact Sheet

    This fact sheet provides an overview of the role of Medicare and Medicaid in serving these beneficiaries, describes the health status of dual Medicare/Medicaid beneficiaries, and discusses issues of managed care and access to care.This fact sheet is a summary of a longer Background Paper (#2132), which is also available. Fact Sheet

  • A Medicare Prescription Drug Benefit: Implications for Medicaid and Low-Income People

    Report

    The Senate and House of Representatives each approved legislation in June of 2003 that would establish outpatient prescription drug coverage for Medicare beneficiaries as part of Medicare program reform. Among the key differences in the House and Senate bills that still must be addressed are the treatment of Medicaid beneficiaries and the structure of low-income subsidy programs. The way in which these issues are resolved will have major implications for Medicaid beneficiaries, other low-income individuals,…

  • Standard Medicare Drug Benefit, 2006 Chart

    Report

    Standard Medicare Drug Benefit, 2006 Out-of-pocket drug spending for Medicare beneficiaries under the standard Medicare drug benefit described in the Medicare Modernization Act of 2003. Chart (.pdf)

  • Retiree Health Benefits in 2003: Employer Survey

    Report

    This survey, conducted by the Kaiser Family Foundation and Hewitt Associates between June and September 2003 provides detailed information on retiree health programs offered by large private-sector employers. The data in this survey reflect the responses of 408 large firms (private-sector employers with 1,000 or more workers) and provides information on eligibility, benefits, premiums, and total cost in 2003, and offers insights as to what changes employers say they are likely to make in the…

  • Health Care and the 2004 Elections: Medical Liability Reform

    Issue Brief

    Medical Liability Reform   Download a printable .pdf of Health Care and the 2004 Elections: Medical Liability Reform. IssueBackgroundOptions for Assuring Access to Affordable Liability CoverageAssessing Candidate PositionsIssue Sharp increases in medical liability insurance premiums in recent years, and the withdrawal of some insurers from this market have focused the attention of health care providers, patients, and policymakers on reform of the medical liability system. Of additional concern is that the fear of liability causes…