Medicare

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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. 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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  • Overview of Medicare Part D Organizations, Plans and Benefits By Enrollment in 2006 and 2007

    Report

    This chartpack provides detailed information about Medicare beneficiaries’ enrollment in the many private drug plans available to them in 2007. The charts demonstrate that a relatively small number of companies which captured the most enrollees in 2006, the new benefit’s first year, continued to lead in market share in the current year. In addition, most enrollees in 2007 are in plans without gap coverage – with about 11.8 million people potentially at risk for reaching…

  • Rethinking Medicaid’s Financing Role for Medicare Enrollees

    Issue Brief

    This issue brief examines coverage of the nearly 9 million "dual eligible" beneficiaries, the low-income elderly and persons with disabilities who are enrolled in both Medicare and Medicaid. It explores the national and state impacts of shifting the financing of selected services for dual eligibles from Medicaid to Medicare, including having the federal government pick up the full cost of Medicare premiums, cost-sharing and gaps in Medicare-covered services and long-term care services for this population.…

  • Chartpack: Kaiser Health Tracking Poll — April 2009

    Poll Finding

    This document contains the chartpack from the April Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted April 2 through April 8, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (902) and cell phone (301, including 98 who had no landline telephone) were carried out in English and Spanish. The margin of…

  • The Obama Administration’s 2010 Call Letter for Medicare Advantage and Prescription Drug Plans: Implications for Beneficiaries

    Issue Brief

    On March 30, 2009, the Centers for Medicare & Medicaid Services issued the 2010 “call letter,” which functions as a request for proposals to private health insurers and organizations that want to sponsor Medicare Advantage Plans or Medicare Prescription Drug Plans. This issue brief reviews the call letter — the first issued by the Obama Administration — and examines the implications for beneficiaries of some of the proposed changes, including its emphasis on accountability of health plan sponsors, promoting…

  • Medicare Part D 2009 Data Spotlight: Specialty Tiers

    Issue Brief

    Most Medicare Part D prescription drug plans use tiers with different cost-sharing amounts for generic, preferred, and non-preferred drugs, and also include an additional “specialty” tier for very high cost and unique drugs. This 2009 Part D Data Spotlight examines use of the specialty tier, including the numbers and kinds of drugs included on specialty tiers, what beneficiaries pay for those drugs, and trends over time. The spotlight is one in a series analyzing key…

  • Strategies for Simplifying the Medicare Advantage Market

    Other Post

    Most Medicare beneficiaries have at least 40 Medicare Advantage (MA) plan options to choose from this year. While some favor a robust marketplace, others argue that fewer plan offerings, or more transparent differences across plans designs, would help beneficiaries choose plans most likely to meet their individual needs. While consumers generally show interest in choice and economists see it as enhancing value, research shows that individuals faced with a large number of alternatives often avoid…

  • Explaining Health Reform: Medicare and the New Independent Payment Advisory Board

    Issue Brief

    This brief describes how the new board created under the 2010 health reform law is expected to limit the growth in Medicare spending over time. Starting in 2014, if projected per capita Medicare spending exceeds targets set in the law, the board must recommend ways to reduce Medicare spending, while maintaining quality and access to care for beneficiaries. The board’s recommendations automatically take effect the next year unless Congress adopts an alternative plan to achieve…

  • Medicare Part D 2010 Data Spotlight: Premiums

    Report

    Medicare Part D helps cover the cost of outpatient prescription drugs for 27 million beneficiaries enrolled in private stand-alone prescription drug plans (PDPs) and Medicare Advantage prescription drug (MA-PD) plans. The majority of Part D enrollees pay a monthly premium for Medicare drug coverage. This data spotlight examines premiums for enrolling in Medicare's PDPs in 2010 and trends since 2006.  The spotlight is one in a series analyzing key aspects of the Medicare Part D…

  • Raising Medicare Premiums for Higher-Income Beneficiaries: Assessing the Implications

    Issue Brief

    As policymakers consider ways to slow the growth in Medicare spending as part of broader efforts to reduce the federal debt or offset the cost of other spending priorities, some have proposed to increase beneficiary contributions through higher Medicare premiums. This issue brief explains provisions of current law that impose income-related premiums under Medicare Part B and Part D, describes recent proposals to modify these requirements, and analyzes the potential implications for the Medicare population.

  • Key Issues in Understanding the Economic and Health Security of Current and Future Generations of Seniors

    Issue Brief

    As part of broad deficit-reduction plans, policymakers are considering reforms to the nation's three major entitlement programs - Medicare, Medicaid and Social Security - that could significantly affect the economic security of seniors in their retirement years. This brief examines the role of these programs in ensuring seniors' financial security as well as the challenges facing current and future generations when it comes to economic and health security. Drawing from current research and data, the…