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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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  • How Much Has Medicare Spent on the EpiPen Since 2007?

    Issue Brief

    This data note examines the effects of rising EpiPen prices on Medicare and beneficiaries. We analyze EpiPen spending, in the aggregate and per user, in Medicare Part D between 2007 (the year after the Part D drug benefit took effect, and the year Mylan acquired the product) and 2014 (the most recent year of data available).

  • Private Contracts Between Doctors and Medicare Patients: Key Questions and Implications of Proposed Policy Changes

    Issue Brief

    Changes in Medicare’s private contracting laws could have significant implications for beneficiaries, doctors, and the Medicare program. This brief summarizes the three options that physicians and practitioners currently have for charging Medicare patients, explains how private contracting works in Medicare under current law, and reviews current proposals on changes to private contracting in Medicare, as well as their implications for patients, physicians, and the Medicare program.

  • A Small Number of Drugs Account for a Large Share of Medicare Part D Spending

    Issue Brief

    The Inflation Reduction Act requires the federal government to negotiate the price of certain high-spending drugs covered by Medicare. This analysis provides context for understanding the potential impact of negotiating prices for a limited number of Medicare-covered drugs by identifying the 10 top-selling Part D drugs in 2021, measuring the share of total Part D drug spending accounted for by top-selling drugs that year, and examining changes in spending and use of these drugs since…

  • Seven Million People with Medicare Spend More Than 10% of Income on Part B Premiums – The Reconciliation Bill Could Drive the Number Higher

    Issue Brief

    People with low incomes and limited financial resources can qualify for the Medicare Savings Programs, through which state Medicaid programs provide financial assistance with Medicare premiums and cost sharing. However, provisions in the GOP’s budget reconciliation bill would make it harder for people to enroll in these programs. Many people with Medicare are facing a relatively high financial burden associated with paying Part B premiums, and the reconciliation bill could drive that number higher.

  • Join the Debate: Health Issues in the 2000 Election

    Other Post

    Developed as part of a nonpartisan public education initiative of the Henry J. Kaiser Family Foundation and the League of Women Voters Education Fund, this guide provides basic facts about five key health policy topics candidates are discussing in the 2000 election. These topics include health coverage for the uninsured, managed care and patients' rights, Medicare reform, prescription drug coverage for seniors, and long-term care. The guide frames each area and describes major proposals that…

  • The Implications of the Medicare Prescription Drug Benefit for Dual Eligibles

    Other Post

    Three new reports focus on one of the biggest challenges in the implementation of the Medicare Modernization Act, the transitioning of drug coverage for individuals dually eligible for Medicaid and Medicare, who now get their drug coverage from Medicaid, to the new Medicare benefit. The New Medicare Prescription Drug Law: Issues for Enrolling Dual Eligibles into Drug Plans Medicare's New Prescription Drug Benefit: The Voices of People Dually Covered by Medicare and Medicaid Implications of…

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

    Report

    Navigating Medicare and Medicaid: Resource Guides for People with Disabilities, Their Families, and Their Advocates These guides explain 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 give people with disabilities new information to help them get the most from these programs. Navigating Medicare and Medicaid, 2005 Keeping Medicare and Medicaid When You Work, 2005

  • Summary of Final Regulations Implementing the New Medicare Prescription Drug Benefit

    Issue Brief

    This document summarizes the final regulations to implement the new Medicare prescription drug benefit. The regulations were published by the Centers for Medicare and Medicaid Services (CMS) as a final rule in the Jan. 28 Federal Register. It provides an overview that allows interested parties to obtain information about specific provisions of the law. The summary was prepared by Health Policy Alternatives Inc. on behalf of the Kaiser Family Foundation. Issue Brief (.pdf)