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.

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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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  • Income-Related Premiums in Medicare: Who Pays, and How Much Do They Pay?

    News Release

    Since 2007, seniors with incomes greater than $85,000 have had to pay higher premiums for Medicare than their counterparts with lower incomes.  Six percent of Medicare Part B enrollees are expected to pay higher monthly premiums in 2015, ranging from $147 to $336, depending on their income.  Lawmakers on Capitol Hill are considering whether to increase these income-related premiums to help offset the federal cost of repealing the Sustainable Growth Rate (SGR) payment formula, a…

  • New Study Provides Insight and Analysis to Help Explain the Medicare Spending Slowdown

    News Release

    Medicare, the federal health program that provides health care and coverage to 54 million seniors and younger adults with permanent disabilities, is in the midst of an unprecedented slowdown in spending growth.  A new issue brief from the Kaiser Family Foundation, How Much of the Medicare Spending Slowdown Can be Explained? Insights and Analysis from 2014, examines the factors that help explain why Medicare is on track to spend an estimated $580 billion in 2014,…

  • Health Affairs Article: At Least Half of New Medicare Advantage Enrollees Had Switched From Traditional Medicare During 2006-11

    Issue Brief

    In an article in Health Affairs, researchers from the Kaiser Family Foundation counter the popular misperception that the steady rise in Medicare Advantage enrollment has been driven by members of the Baby Boom generation overwhelmingly choosing the private plans as they become eligible for Medicare. Their study examines the 2006-2011 growth in Medicare Advantage enrollment and finds that a majority of new enrollees in Medicare Advantage in each year were, in fact, seniors switching from…

  • New Report on the “Rising Cost of Living Longer” Details Medicare Spending by Age

    News Release

    A new report, The Rising Cost of Living Longer: Analysis of Medicare Spending by Age for Beneficiaries in Traditional Medicare, from the Kaiser Family Foundation takes a detailed look at per person Medicare spending by age and by service among the nearly 30 million people covered by traditional Medicare in 2011

  • Seniors and Income Inequality: How Things Get Worse With Age

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses why seniors need to be included in the national discussion on income inequality, especially as proposals to change Medicare and Social Security are considered.

  • Seniors and Income Inequality: How Things Get Worse With Age

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman discusses why seniors need to be included in the national discussion on income inequality, especially as proposals to change Medicare and Social Security are considered. All previous columns by Drew Altman are available.

  • Medicare Advantage 2015 Spotlight: Enrollment Market Update

    Issue Brief

    This Data Spotlight reviews national and state-level enrollment trends as of March 2015 and examines variation in enrollment by plan type and firm. It analyzes the most recent data on premiums, out-of-pocket limits, Part D cost-sharing for drugs, and plans’ quality ratings for Medicare Advantage enrollees.

  • Medicare Advantage Enrollment Continues to Climb, but Financial Protections for Enrollees Are Eroding 

    News Release

    Enrollment in Medicare Advantage continues to climb steadily as spending reductions enacted in the Affordable Care Act reduce historical overpayments to the private plans, according to a new analysis by the Kaiser Family Foundation. But limits on out-of-pocket spending for Medicare-covered services are rising, providing less protection for enrollees with relatively high health care expenses. Medicare Advantage enrollment grew in virtually all states and reached 16.8 million beneficiaries as of March 2015, an increase of…

  • Amid Merger Talk, a Look at Health Insurers’ Medicare Business

    From Drew Altman

    With recent news about possible health insurance company mergers, Drew Altman looks beyond the impact on Wall Street to how mergers could affect Medicare beneficiaries in this column for The Wall Street Journal's Think Tank.