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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  • What Might a Repeal of the Affordable Care Act Mean for Medicare?

    News Release

    As Republican policymakers consider how to repeal and replace the Affordable Care Act (ACA), they are likely to face a number of decisions about whether to retain any of the law’s changes to Medicare. Repealing the ACA has potential implications for Medicare spending, beneficiaries, and other stakeholders, according to a new Kaiser Family Foundation brief. A full repeal of the ACA would undo all of the law’s changes to Medicare and would increase Medicare spending,…

  • Medicare Advantage Plans in 2017: Short-term Outlook is Stable

    Issue Brief

    This issue brief analyzes the number and variety of Medicare Advantage plan choices available to beneficiaries in 2017. It describes trends in number of Medicare Advantage plans and plan quality ratings, and new information on plan premiums, out-of-pocket expense limits, and other plan features. This spotlight is part of a series of spotlights tracking key changes in the Medicare Advantage program.

  • Turning the Spotlight on Medicare Advantage for 2017

    News Release

    Medicare Advantage plans, which consist primarily of HMOs and PPOs, now cover almost 18 million people – nearly one-third of all Medicare beneficiaries.  Medicare Advantage plans have been in the news lately because the proposed merger between Aetna and Humana, which together account for one-quarter of all Medicare Advantage enrollees, could further consolidate the Medicare Advantage market. A Kaiser Family Foundation analysis, featuring the latest publicly available data on the 2017 Medicare marketplace, examines new…

  • Medicare Part D Spending on the EpiPen Increased More than 1000 Percent from 2007 to 2014

    News Release

    As policymakers in Washington scrutinize the rising cost of the EpiPen auto-injector, a new analysis from the Kaiser Family Foundation shows that Medicare Part D spending for the potentially life-saving device increased by more than 1000 percent between 2007, the year after the Part D drug benefit took effect, and 2014, the most recent year for which data are available. The higher spending partly results from more Part D enrollees using EpiPens during that period,…

  • Few People Switch Medicare Advantage Plans Each Year, Raising Questions About Whether Seniors Have the Tools and Information They Need To Compare Plans  

    News Release

    A small share of Medicare Advantage enrollees switch plans each year, but those who do tend to pick plans with lower premiums and out-of-pocket limits than the plans they left behind, according to a new analysis by the Kaiser Family Foundation. Eleven percent of enrollees voluntarily switched from one Medicare Advantage plan to another between 2013 and 2014, the analysis finds, while another four percent were forced to change because their Medicare Advantage plan exited…

  • Policy Insight Examines a Key Barrier That Younger Medicare Beneficiaries with Disabilities Face in Getting Supplemental Insurance Coverage

    News Release

    In a new policy insight, the Kaiser Family Foundation’s Tricia Neuman and Juliette Cubanski examine a 1990 federal law that ensures that people age 65 and older are able to buy a Medigap policy when they sign up for Medicare, but denies younger Medicare beneficiaries with disabilities the same right unless they live in a state that requires it.

  • Medicare Drug Plan Enrollees Would Face an Average 9 Percent Premium Increase Unless They Switch Plans During Open Enrollment, New Analysis Finds

    News Release

    Current enrollees in stand-alone Medicare Part D plans are projected to face an average 9 percent increase in premiums if they remain in their current plan for 2017, according to an analysis released today by the Kaiser Family Foundation. During Medicare’s 2017 open enrollment period, which runs from Oct. 15 through Dec. 7, Medicare beneficiaries in each state will have a choice of 22 stand-alone Part D drug plans (PDPs), on average. This is fewer…

  • Modifying Traditional Medicare’s Benefit Design Could Reduce Federal Spending But With Cost Tradeoffs Between Beneficiaries and The Federal Government

    News Release

    Revamping traditional Medicare’s benefit design and restricting “first-dollar” supplemental coverage could reduce federal spending, simplify cost sharing, protect against high medical costs, decrease out-of-pocket spending for many beneficiaries, and provide more help to those with low incomes -- but would be unlikely to achieve all of these goals simultaneously.

  • Analysis Finds End-of-Life Medicare Spending Declines With Age Among Seniors

    News Release

    Among beneficiaries who died in 2014, Medicare spent significantly more per person on medical services for seniors in their late sixties and early seventies than on older beneficiaries, according to a new data note from the Kaiser Family Foundation. The analysis comes at a time when physicians can now be reimbursed by Medicare for end-of-life care discussions with their patients. The analysis of Medicare claims data through 2014 finds that among those who died in…

  • What Paul Ryan’s Stance on 2016 Means for Health Care

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman discusses the implications of Paul Ryan’s decision to rule out being drafted as a Republican presidential candidate for the 2017 health care agenda and how it could focus greater attention on proposals to change Medicare and Medicaid along with the Affordable Care Act.