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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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  • Medicare Part D: A First Look at Prescription Drug Plans in 2017

    Issue Brief

    This issue brief provides an overview of the 2017 Medicare Part D stand-alone prescription drug plan marketplace, based on analysis of data from the Centers for Medicare & Medicaid Services. The brief focuses on data for 2017 and changes over time in plan availability, premiums, benefit design, cost sharing, and low-income subsidy plan availability.

  • Medicare and Medicaid at 50

    Video

    With Medicare and Medicaid turning 50 this year, this updated video provides a brief history of both programs, including: an examination of the health care, social and political landscape that gave rise to them, the significant ways each program has evolved over five decades, and the important roles they play in the U.S. health care system. The video includes archival footage, as well as commentary and perspective from policymakers, government officials and experts.

  • 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.

  • Medicare Advantage Networks Included 46 Percent of Physicians in a County, On Average  

    News Release

    Medicare Advantage plan networks included 46 percent of all physicians in a county, on average, according to a new analysis from the Kaiser Family Foundation. The study, using 2015 data, is the first to examine the size and composition of physician networks among increasingly popular Medicare Advantage private plans, which now cover 19 million people, or one-third of the Medicare population. The study, which analyzed data from 391 plans offered by 55 insurers in a…

  • Medicare Part D: A First Look at Prescription Drug Plans in 2018

    Issue Brief

    This issue brief provides an overview of the 2018 Medicare Part D stand-alone prescription drug plan landscape, the largest segment of the Part D marketplace, It includes national and state-level data on plan availability, premiums, benefit design, cost sharing, information about premium-free plans for low-income beneficiaries, and information about the top ten Part D plans in 2018.

  • One Big Thing People Don’t Know About Single Payer

    From Drew Altman

    In this Axios column, Drew Altman discusses a challenge for single payer which has not received much attention – a large share of the American people do not think they would have to change their current health insurance arrangements if there were a Medicare-for-all style single payer plan.

  • Bernie Sanders, Hillary Clinton, and Medicare for All

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman explores the differing positions of presidential candidates Hillary Clinton and Bernie Sanders on a single payer or Medicare-for-all health care system and whether Democratic voters consider it an important factor in the 2016 primaries.

  • Allowing Medicare to Negotiate Drug Prices Is A Popular Idea But May Not Produce Substantial Savings

    News Release

    In response to rising drug costs, some policymakers and presidential candidates, including Republican Donald Trump and Democrats Hillary Clinton and Bernie Sanders, have proposed allowing Medicare to negotiate directly with pharmaceutical companies over the price of prescription drugs, in contrast to the current approach under Medicare Part D drug where private plans do the negotiating.  A version of this proposal was also included in the Obama Administration’s FY 2016 and FY 2017 budgets. While the…