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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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  • What Could a Medicaid Per Capita Cap Mean for Low-Income People on Medicare?

    Issue Brief

    Policymakers are currently considering proposals that would fundamentally change the structure and financing of Medicaid, and potentially affect 11 million people on Medicare. This brief discusses the potential implications of Medicaid per capita cap or block grant proposals for the 11 million low-income seniors and people with disabilities on Medicare. It also describes how the per capita cap model proposed in the American Health Care Act could potentially affect low-income people on Medicare who receive…

  • Kaiser Health Tracking Poll – January 2018: The Public’s Priorities and Next Steps for the Affordable Care Act

    Feature

    With the 2018 midterm elections still about ten months away, the January Kaiser Health Tracking poll examines what issues voters most want 2018 midterm candidates to talk about during their upcoming campaigns. Health care is at the top of a group of issues but health care is less important to Republicans and among voters in battleground states. While Congress is currently debating a budget to keep the government funded beyond February 8, 2018, the poll…

  • More Than One-Third of People with Traditional Medicare Spent at Least 20 Percent of Their Total Income on Health Care in 2013 

    News Release

    Health care costs are a substantial and growing burden for many people on Medicare and are projected to consume a larger share of total income over time, according to a new analysis from the Kaiser Family Foundation. The study, Medicare Beneficiaries’ Out-of-Pocket Health Care Spending as a Share of Income Now and Projections for the Future, finds that more one-third of people with traditional Medicare spent at least 20 percent of their total income on…

  • How ACA Repeal and Replace Proposals Could Affect Coverage and Premiums for Older Adults and Have Spillover Effects for Medicare

    Issue Brief

    This brief explains the key AHCA provisions that would reshape the private market to more closely resemble the pre-Affordable Care Act period, and the effects of these changes on adults ages 50-64. The brief also discusses how changes to Medicaid could affect older, low-income adults, and how an increase in the number of uninsured older adults could have implications for the Medicare program in the future.

  • Revisiting ‘Skin in the Game’ Among Medicare Beneficiaries: An Updated Analysis of the Increasing Financial Burden of Health Care Spending From 1997 to 2005

    Issue Brief

    This issue brief presents an analysis of the financial burden of out-of-pocket health care spending for Medicare beneficiaries between 1997 and 2005. The analysis shows median out-of-pocket spending as a share of Medicare beneficiaries' income increased between 1997 and 2005, from 11.9 percent to 16.1 percent. For some beneficiaries, the spending burden was even greater, with 25 percent of people on Medicare spending nearly one-third or more of their income on health care.

  • Medigap Enrollment Among New Medicare Beneficiaries: How Many 65-Year Olds Enroll In Plans With First-Dollar Coverage?

    Issue Brief

    On March 26, 2015, the House of Representatives passed H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015, which would replace the Sustainable Growth Rate (SGR) formula, among other changes; the bill is currently pending in the U.S. Senate. H.R. 2 includes a provision that would prohibit Medicare supplemental insurance (Medigap) policies from covering the Part B deductible for people who become eligible for Medicare on or after January 1, 2020. This data…

  • Medicare: An Overview

    Feature

    This slideshow explains key elements of the Medicare program, which now provides health coverage to 55 million people — including 46 million people age 65 and older and another 9 million younger adults with permanent disabilities.

  • More Than 1 in 3 Nursing Homes Received Relatively Low Overall Ratings on Nursing Home Compare

    News Release

    More than one third of the nation’s 15,500 nursing homes, accounting for 39 percent of all nursing home residents, received relatively low ratings of 1 or 2 stars under the federal government’s recently revamped Five-star Quality Rating System, according to a new analysis by the Kaiser Family Foundation. The rating system, overseen by the Centers for Medicare and Medicaid Services, assigns ratings of 1 to 5 stars to all Medicare- and Medicaid-certified nursing homes based…