Medicare

NEW AND NOTEWORTHY

What to Know About Medicare Coverage of Telehealth

Congress has repeatedly extended pandemic-era flexibilities around Medicare coverage of telehealth, but most such flexibilities remain temporary. This brief answers key questions about the current scope of Medicare telehealth coverage, including both temporary and permanent changes adopted through legislation and regulation, and future policy considerations.

Changes to the Medicare Advantage Program Enhance Some Consumer Protections But Roll Back Others

CMS recently finalized policies as part of the 2027 Medicare Advantage final rule that both enhance consumer protections and roll back changes to the Medicare Advantage program that were intended to protect consumers. These changes have gotten less attention than payment issues and changes to the star ratings system, which also affect plan payments, but could have implications for Medicare beneficiaries.

Examining the Potential Impact of Medicare’s New WISeR Model

A federal initiative to establish new prior authorization requirements in traditional Medicare, called the Wasteful and Inappropriate Service Reduction (WISeR) model, is likely to have only modest impact in its first year.

State Profiles for Dual-Eligible Individuals

This data collection draws on Medicare and Medicaid administrative data to present national and state-level information on people who are covered by both Medicare and Medicaid, referred to as dual-eligible individuals (also known as dually-enrolled beneficiaries).

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. u003cbru003eu003cbru003eExplore 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.u003cbru003eu003cbru003eu003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022 data-type=u0022linku0022 data-id=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003eRelated:u003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003e FAQs on Medicare Financing and Trust Fund Solvencyu003c/au003eu003c/au003e

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  • Medicaid-Related Provisions in the Ticket to Work and Work Incentives Improvement Act of 1999

    Report

    In December, the President signed into law the Ticket to Work and Work Incentives Improvement Act of 1999, which includes provisions that will give states additional options for extending Medicaid coverage to working disabled individuals. This memo presents an overview of the eligibility options offered under the new legislation (Publication #2187). A related publication, Medicaid Eligiblity for Individuals with Disabilities (Publication #2150), provides a general overview of federal Medicaid eligibility policy for the low-income disabled…

  • 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…

  • Prescription Drug Coverage for Medicare Beneficiaries

    Other Post

    A Side-by-Side Comparison of Selected Proposals as of February 15, 2000 This document provides a side-by-side comparison of five major federal proposals that have been considered to provide outpatient prescription drug coverage to Medicare beneficiaries. It begins with a summary table comparing key features of each proposal, followed by a detailed comparison of the following major proposals: Breaux/Frist, Clinton, Kennedy/Stark, Snowe/Pallone, and Bilirakis/Peterson. For more background on the issue of prescription drugs for Medicare beneficiaries,…

  • Dementia and Medicare Managed Care: A Growing Challenge for Health Plans

    Report

    The American Bar Association Commission on Legal Problems of the Elderly explored the views of Medicare HMOs on enrolling and delivering services to Medicare beneficiaries with dementia. The Commission conducted detailed interviews with professionals at eight diverse Medicare+Choice organizations. Their report provides background information on health care decision-making law and the Medicare program's laws and regulations, and focuses on survey findings in six key areas: marketing, enrollment, health assessments, health care delivery, advance directives, and…

  • The Public’s Health Care Agenda for the New President and Congress

    Poll Finding

      The Public's Health Care Agenda for the New President and Congress This survey captures the public's attitudes regarding the health care agenda for President Obama and the new Congress in 2009. It assesses the relative priority placed on health care by the American public as part of addressing the economic recession and as a large scale reform issue. The public's priorities for health care reform and their views on a range of other health…

  • The Role of PBMs in Managing Drug Costs: Implications for a Medicare Drug Benefit

    Other Post

    Extending a drug benefit to Medicare beneficiaries has been a highly publicized issue in recent months. To address the question of how to finance and administer such a benefit while controlling its cost, some have proposed using pharmacy benefit managers (PBMs)--companies that administer pharmaceutical benefits for health plans, HMOs, and employers while managing drug utilization and obtaining discounts from both retail pharmacies and manufacturers. Most recently, the Clinton Administration introduced a proposal for a Medicare…

  • Health News Index – March/April 2000

    Poll Finding

    Health News Index March/April, 2000 The March/April 2000 edition of the Kaiser Family Foundation/Harvard School of Public Health, Health News Index includes questions about major health stories covered in the news, including questions about the Supreme Court's ruling on the the Food and Drug Administration's authority to regulate the marketing of tobacco products. The survey is based on a national random sample of 1,012 Americans conducted March 31-April 3, 2000 which measures public knowledge of…

  • Variations in State Medicaid Buy-in Practices for Low-Income Medicare Beneficiaries: A 1999 Update

    Report

    This report updates a 1997 Foundation report to assess how states are implementing financial protections for the 16 million Medicare beneficiaries who are low-income. These protections, generally referred to as "buy-in programs," help low-income Medicare beneficiaries meet Medicare's cost-sharing requirements by using state Medicaid programs to pay either all or some portion of premiums, deductibles, and coinsurance amounts. Using information collected through a survey of state Medicaid directors and consumer advocates, the update seeks to…

  • Long-Term Care:  Medicaid’s Role and Challenges

    Issue Brief

    Long-Term Care: Medicaid's Role and Challenges This Policy Brief examines Medicaid's role in providing long-term care services. It describes long-term care services, the population that needs these services, and how people get long-term care services. It provides an overview of health insurance coverage of persons with long-term care needs and describes both Medicare's and Medicaid's role in providing these services. It also examines some of the policy issues and challenges involved in providing long-term care…

  • How Medicare HMO Withdrawals Affect Beneficiary Benefits, Costs, and Continuity of Care

    Report

    Results from the 1999 Survey of Experiences with Medicare HMOs This report examines the effects of Medicare HMO withdrawals on elderly and disabled beneficiaries who were involuntarily disenrolled from their HMO at the end of 1998. Based on a nationally-representative survey, the report describes new insurance arrangements made by beneficiaries after their HMO withdrew and considers the effects of this insurance transition on benefits, costs, and continuity of care. The study finds that most beneficiaries…