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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  • An Examination of Medicare Private Fee-for-Service Plans

    Issue Brief

    This March 2007 issue brief, commissioned by the Kaiser Family Foundation, provides insight Medicare private fee-for-service plans, the most rapidly growing type of Medicare Advantage plan. As of February 2007, these plans enrolled 1.3 million beneficiaries, up from just 209,000 in December 2005. The paper examines the history of these plans, their key features, trends related to their availability and enrollment and their implications for Medicare beneficiaries. Jonathan Blum, Ruth Brown and Miryam Frieder of…

  • Medicare Part D 2008 Data Spotlight: Specialty Tiers

    Issue Brief

    This Medicare Part D data spotlight focuses on the use of specialty tiers for high-cost and injectible drugs in Medicare Prescription Drug Plans in 2008. It finds that the number of plans with specialty tiers has nearly doubled since 2006. It also looks at the drugs assigned to specialty tiers, the beneficiary cost sharing structure, and policy implications such higher out-of-pocket expenses and selection issues among beneficiaries who evaluate plans based on cost sharing. This…

  • Examining Sources of Supplemental Insurance and Prescription Drug Coverage Among Medicare Beneficiaries: Findings from the Medicare Current Beneficiary Survey, 2007

    Report

    This updated chartpack presents sources of supplemental and prescription drug coverage among Medicare beneficiaries in 2007, the most recent year for which national data are available. The chartpack looks at variations in supplemental and prescription drug coverage by income, race/ethnicity, age, urban/rural location, and health status. It also examines characteristics of Medicare beneficiaries with low incomes who are not enrolled in a Part D plan or receiving Part D low-income subsidies. Prepared by Kaiser Family…

  • Medicare Part D 2010 Data Spotlight: Coverage of Top Brand-Name and Specialty Drugs

    Issue Brief

    This Part D Data Spotlight documents the wide variations across the private stand-alone drug plans with respect to coverage of drugs, what enrollees pay for those drugs, and restrictions and limitations placed on their use. These variations have potentially significant implications for beneficiaries’ access to medications and out-of-pocket costs. The spotlight is one in a series analyzing key aspects of the Medicare Part D drug plans that will be available to beneficiaries in 2010. The…

  • Reaching for the Stars: Quality Ratings of Medicare Advantage Plans, 2011

    Issue Brief

    New: Medicare Advantage Plan Star Ratings and Bonus Payments in 2012 In 2012, Medicare Advantage plans will be awarded additional payments based on their quality ratings as a result of the 2010 health reform law. The Centers for Medicare and Medicaid Services has proposed a demonstration that would modify the quality-based payments for plans, providing additional payments for 2012 to 2014. This policy brief by the Kaiser Family Foundation examines the quality ratings of private…

  • The Role of Medicare and Beneficiaries in the Deficit-Reduction Debate

    Event Date:
    Event

    This Kaiser Family Foundation briefing examined how Medicare reform options now under consideration might work and their implications for beneficiaries and taxpayers. As context for understanding the potential effects of reforms, the briefing looked at the current and projected income and assets of people on Medicare, out-of pocket health care spending and the ability of Medicare beneficiaries to absorb rising costs. The Foundation also released a new report and video profiling Medicare families and the…

  • Medicare Part D Spending Trends: Understanding Key Drivers and the Role of Competition

    Issue Brief

    This brief commissioned by the Foundation examines factors that contributed to Medicare's lower-than-expected spending on prescription drugs under the Medicare Part D drug benefit that started in 2006. Since its launch, Medicare has spent about 30 percent less on Part D benefits than the Congressional Budget Office originally projected. Some cite the program's design, with private plans competing for enrollment, as the driving factor in lower spending; others point to factors in the overall market…

  • Medicare Advantage 2012 Data Spotlights

    Report

    The Kaiser Family Foundation has issued a series of data spotlights and examining the Medicare Advantage plan options available in 2012 and trends affecting the Medicare Advantage marketplace. These analyses were prepared by researchers at Mathematica Policy Research Inc. and the Kaiser Family Foundation. Plan Availability and Premiums Enrollment Market Update

  • The Olmstead Decision: Implications for Medicaid

    Issue Brief

    In June, 1999, the Supreme Court rule in Olmstead v L.C. that states were required to provide services to persons with disabilities in community settings rather than institutions, if certain conditions were met. This Policy Brief provides an overview of the Olmstead case, including the facts, the court ruling, and the disposition of the case. In addition, the brief describes the issues surrounding implementation and the implications this ruling could have for state Medicaid programs.…