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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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  • The Kaiser Family Foundation/Harvard School of Public Health Medicare Prescription Drug Survey – Toplines

    Poll Finding

    These toplines are part of a survey by the Kaiser Family Foundation and Harvard School of Public Health that examines public opinion on the Medicare prescription drug debate. The survey, a follow-up to a broader, more comprehensive survey released in June 2003 about the Medicare program and proposed changes, finds that a majority of seniors want Congress to pass Medicare prescription drug legislation this year, but most worry that they will still pay too much…

  • The New Medicare Prescription Drug Law:  Issues for Dual Eligibles with Disabilities and Serious Conditions

    Issue Brief

    The New Medicare Prescription Drug Law: Issues for Dual Eligibles with Disabilities and Serious Conditions The new issue paper discusses the challenges the new Medicare drug program faces in meeting the needs of dual eligible individuals with disabilities, who tend to have extensive, complex and varying needs. The brief examines four key questions about how the new benefit will serve dual eligibles with disabilities and profiles some individuals from this population for whom prescription drugs…

  • Issues for Medicare Beneficiaries in Long-Term Care Facilities: An Analysis of the MMA and Proposed Regulations

    Issue Brief

    This paper, by Vicki Gottlich, J.D., of the Center for Medicare Advocacy, looks at issues related to the new Medicare prescription drug benefit for people with Medicare who live in nursing homes or other long-term-care settings. It is one in a series commissioned by the Kaiser Family Foundation that analyzes issues surrounding the implementation of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the proposed regulations. Issue Brief (.pdf)

  • Health Care and the 2004 Elections: Medical Liability Reform

    Issue Brief

    Medical Liability Reform   Download a printable .pdf of Health Care and the 2004 Elections: Medical Liability Reform. IssueBackgroundOptions for Assuring Access to Affordable Liability CoverageAssessing Candidate PositionsIssue Sharp increases in medical liability insurance premiums in recent years, and the withdrawal of some insurers from this market have focused the attention of health care providers, patients, and policymakers on reform of the medical liability system. Of additional concern is that the fear of liability causes…

  • The Distributional Consequences of  Medicare Premium Support Proposal

    Other Post

    The Distributional Consequences of a Medicare Premium Support Proposal This article analyzes the expected distributional impact of enacting a premium support proposal for Medicare based on legislation introduced by Sen. Breaux and Sen. Frist in 1999. This legislation suggested that the Federal Employees Health Benefits plan be used as a model for Medicare. The article simulates impacts in three areas: among beneficiaries who choose to retain fee-for-service coverage, between different geographic areas, and according to…

  • Navigating Medicare and Medicaid, 2005: A Resource Guide for People with Disabilities, Their Families, and Their Advocates

    Report

    This guide explains the critical role Medicare and Medicaid have come to play in the lives and the futures of roughly 20 million children, adults, and seniors with disabilities - and gives people with disabilities new information to help them get the most from these programs. Full PDF Report (.pdf) Section 1: Introduction HTML PDF Section 2: Medicare HTML PDF Section 3: Medicaid HTML PDF Section 4: Interaction Between Medicare and Medicaid HTML PDF

  • Low-Income Subsidies for the Medicare Prescription Drug Benefit: The Impact of the Asset Test

    Report

    This study assesses the impact of the requirement that low-income people with Medicare meet an asset test in order to receive additional help paying premiums and cost-sharing under the new Medicare drug benefit. Report (.pdf) American Journal of Managed Care Article: Who Will Be Denied Medicare Prescription Drug Subsidies Because of the Asset Test? (January 2006) (.pdf)

  • Dual Eligibles: Medicaid Enrollment and Spending for Medicare Beneficiaries in 2003

    Issue Brief

    Dual Eligibles: Medicaid Enrollment and Spending for Medicare Beneficiaries in 2003 This report provides the latest national and state data on Medicaid enrollment and spending for individuals enrolled in both Medicaid and Medicare, also knows as dual eligibles. Nationally, there are 7.5 million dual eligibles and while they comprise 14 percent of the Medicaid population, they account for 40 percent of Medicaid spending. Issue Paper (.pdf)

  • The Medicare Drug Benefit: Beneficiary Perspectives Just Before Implementation

    Poll Finding

    This comprehensive survey of seniors about the Medicare drug benefit finds that many seniors remain uncertain about how the new benefit will affect them and unsure about whether they will enroll. Seniors who say they understand the benefit well are more likely to report favorable views than those who do not. The survey examines in depth what seniors know and understand about the new benefit and what they think about its potential helpfulness. It was…