Medicare

NEW AND NOTEWORTHY

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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  • March/April 2005 Kaiser Health Poll Report – Toplines

    Poll Finding

    Health News Index March/April, 2005 The March/April Kaiser Health Poll Report featured topic explores the public's views on the Medicare prescription drug benefit. This featured topic covers the historical perspective from before the law was passed as well as current views and understanding of the benefit, including how seniors are getting information about this plan, whether they think they have enough information and whether or not they plan to enroll. Additionally, the featured topic explores…

  • Medicare’s Role for Dual Eligible Beneficiaries

    Issue Brief

    About 9 million low-income seniors and younger people with disabilities in the United States are covered by both Medicare and Medicaid. This brief examines the role of Medicare in providing health coverage for these beneficiaries. Medicare is the primary source of health insurance, while Medicaid provides supplemental coverage, helping with premiums and cost-sharing and paying for services not covered by Medicare. This brief examines overall and per capita Medicare spending for these beneficiaries, including variations…

  • Briefing – Medicare: A Primer

    Event Date:
    Event

    This briefing provided an overview of the Medicare program and its role in the health care system. Panelists discussed who is eligible for Medicare, what benefits are covered and how the program is administered. Medicare financing and the program's role in health reform was also explained. More information on Medicare from the Kaiser Family Foundation can be found in the related documents below. This March 11 briefing was cosponsored by the Kaiser Family Foundation and…

  • Medicare Advantage Plan Star Ratings and Bonus Payments in 2012

    Report

    This report looks at the star ratings that have been used for many years to help consumers compare plans, and examines how Medicare Advantage quality scores will interact with plan payments, beginning in 2012. To encourage Medicare Advantage plans to provide quality care, the 2010 health reform law authorized Medicare to pay plans bonuses beginning in 2012 if they receive four or five stars on the program’s five-star quality rating system, or are unrated. Building…

  • The Landscape of Private Firms Offering Medicare Prescription Drug Coverage in 2006

    Issue Brief

    describes key characteristics of the organizations that offer the new Medicare drug benefit and analyzes how companies are positioning themselves to attract Medicare enrollees. • Seven of the 10 organizations that sponsor stand-alone prescription drug plans nationwide are based in commercial insurance firms with substantial Medicare Advantage experience, and three of the 10 firms are in the pharmacy benefit management and service sector. • Nine of the 10 organizations that sponsor stand-alone prescription drug plans…

  • How States Are Responding to the Challenge of Financing Health Care for Retirees

    Report

    State governments are an important source of health insurance coverage for retired state employees. Confronted with rising health care costs, budget deficits, and an overall downturn in the economy, this report describes how states are responding to the challenge of financing health care for retirees who tend to be sicker and more costly to cover than active workers. This study, based on survey responses from 43 states and the District of Columbia, captures information on…

  • New Medicare Drug Benefit’s Impact on States and Low-Income Beneficiaries

    Other Post

    New Medicare Drug Benefit's Impact on States and Low-Income Beneficiaries The recently signed Medicare prescription drug bill transfers responsibility for providing prescription drug coverage to dual-eligible beneficiaries from Medicaid to Medicare and creates a new subsidy program for low-income Medicare beneficiaries. These changes will have a major impact on state Medicaid programs both fiscally and administratively and it will also mean major changes for low-income beneficiaries' drug coverage. Presentation: Medicare Prescription Drugs and Low-Income Beneficiaries…

  • Consumer Protection Issues Raised by the Medicare Prescription Drug, Improvement, and Modernization Act of 2003

    Report

    This paper identifies and examines consumer protection issues that arise from the Medicare Prescription Drug, Improvement, and Modernization Act of 2003. Key issue areas include: beneficiary information, marketing, enrollment and disenrollment, the drug benefit package and cost-sharing, the appeals process, concerns for low-income beneficiaries, challenges for nursing home issues, and fraud and abuse. Report (.pdf)

  • Implications of the New Medicare Prescription Drug Benefit for State Medicaid Budgets

    Issue Brief

    For a number of years, Governors and other state policymakers have maintained that Medicare - rather than state Medicaid programs - should play the key role in providing prescription drug coverage to Medicare beneficiaries, including those who also qualify for Medicaid because they are impoverished and/or have extensive health care needs (i.e, the "dual eligibles"). Although the new Medicare prescription drug benefit law shifts drug coverage for dual eligibles from Medicaid to Medicare, it does…

  • New Resources and Briefing Explore Nursing Home Reform Twenty Years After Passage of Landmark Law

    Event Date:
    Event

    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), the Kaiser Family Foundation released new resources and cosponsored a Washington, D.C. briefing. Among the resources released were new opinion poll results on the public’s views about the quality of long-term care services in the United States; the short film, “Nursing Home Reform: Then…