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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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  • Solvency or Affordability?  Ways to Measure Medicare’s Financial Health

    Report

    Solvency or Affordability? Ways to Measure Medicare's Financial Health This report examines different ways of measuring Medicare s financial health and considers their implications for the future of the program and the people it serves. Using an alternative measure of Medicare's long-term affordability that focuses on workers' capacity to absorb additional costs over time, the analysis concludes that the nation could afford to pay more for Medicare in the future without imposing an undue burden…

  • Issues Facing Medicaid and CHIP

    Event Date:
    Event

    Cindy Mann, senior fellow of the Commission, testified to the Senate Subcommittee on Public Health of the Health, Education, Labor and Pensions Committee on how to sustain and expand health care coverage for low-income children and families, and disabled and elderly people in these challenging times. TESTIMONY Download

  • State Variation in Medicaid Pharmacy Benefit Use Among Dual-Eligible Beneficiaries

    Report

    This study examines Medicaid pharmacy benefit use and spending among beneficiaries dually eligible for Medicare and Medicaid in 10 states by analyzing 1995 enrollment and claims data from a new 12-state database. The study finds that dual-eligibles are relatively high users of the Medicaid pharmacy benefit, with substantial variation in both drug use and spending among this population across the 10 study states. This variation appears to persist independent of beneficiaries' health status and is…

  • The President’s Fiscal Year 2003 Budget:  An Overview of Health Programs

    Report

    The President's Fiscal Year 2003 Budget: An Overview of Health Programs A new chartbook describes the government's overall budget situation and examines the health policies and programs proposed in the President's latest budget. Chartbook View a webcast of A Capitol Hill briefing on budgets and health care

  • Prescription Drug Discount Card Programs: Implications for Medicare Beneficiaries

    Report

    This testimony was delivered by Tricia Neuman, a vice president of the Kaiser Family Foundation, at a Senate Finance Committee hearing on the Bush Administration's Proposals for Medicare Modernization. The statement, which draws upon a report prepared for the Foundation by Health Policy Alternatives, Inc., provides an overview of existing prescription drug discount card programs, describes some of the features of the Administration's recently released proposal for a Medicare-endorsed discount card program, and raises some…

  • Trends in Medicare Supplemental Insurance and Prescription Drug Coverage 1996-1999

    Other Post

    This paper, featured in the February 27, 2002, online issue of Health Affairs, examines trends in Medicare beneficiaries supplemental insurance and prescription drug coverage between 1996 and 1999, using the Medicare Current Beneficiary Survey (MCBS) Access to Care files. It also provides snapshot estimates of coverage among subgroups of Medicare beneficiaries in 1999. The findings from this study provide important context for the debate over current policy proposals to reform Medicare and extend prescription drug…

  • Prescription Drug Discount Cards: Current Programs and Issues

    Report

    As policymakers consider a range of approaches to providing prescription drug coverage to the Medicare population in today s tight budgetary environment, one proposal that has been put forth by the Bush Administration is that of a Medicare-endorsed prescription drug discount card program. This report describes the range of existing discount card programs run by both private sponsors and state governments and provides background information on the implications of this approach to assisting Medicare beneficiaries…

  • A Medicare Buy-In for the Near Elderly: Design Issues and Potential Effects on Coverage

    Report

    This report examines a Medicare-based approach to reducing the ranks of the uninsured that would permit early retirees between the ages of 62 and 65 to purchase coverage under Medicare. The paper begins with an overview of the challenges of insuring the near-elderly and explores the potential effects of a Medicare buy-in on coverage of this population. The authors conclude that, unless premiums for such coverage were low or tied to enrollees' income, this approach…

  • An Analysis of Reforming Medicare Through a ‘Premium Support’ Program

    Report

    An Analysis of Reforming Medicare Through a 'Premium Support' Program This report examines one of the leading approaches to reforming the Medicare program, known as premium support. Under this model, the current Medicare program would be replaced by a system of competing public and private health plans, and the federal government would pay a set amount per beneficiary. The authors conclude that, while premium support could potentially improve Medicare's efficiency and improve quality, traditional Medicare…