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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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  • Lower Flu Vaccination Rates Among Black, Hispanic, and Low-Income Seniors Suggest Challenges for COVID-19 Vaccination Efforts

    Issue Brief

    People 65 and older, who have been hardest hit by COVID-19 in terms of hospitalizations and deaths, are also at high risk of severe flu illness and are more likely to die of the flu than younger people. This analysis explores variation in the rate of flu vaccination among adults ages 65 and older covered by Medicare, and reasons cited for not getting vaccinated, based on data from the 2018 Medicare Current Beneficiary Survey.

  • Medicare Accelerated and Advance Payments for COVID-19 Revenue Loss: More Time to Repay

    Issue Brief

    This brief provides an overview and status update of the Medicare accelerated and advance payment program, which provided $100 billion in loans to Medicare providers in the spring of 2020 to compensate for revenue shortfalls due to the coronavirus pandemic. The brief describes who got the funds, and how these loans are distinct from other funds that providers received, which do not have to be repaid.

  • Medicare Advantage 2021 Spotlight: First Look

    Issue Brief

    For 2021, the average Medicare beneficiary has access to 33 Medicare Advantage plans, the largest number of options available in the last decade, and can choose from plans offered by eight firms. Among the majority of Medicare Advantage plans that cover prescription drugs, 54 percent will charge no premium in addition to the monthly Medicare Part B premium. As in previous years, the vast majority of Medicare Advantage plans will offer supplemental fitness, dental, vision,…

  • How Much Could Medicare Beneficiaries Pay For a Hospital Stay Related to COVID-19?

    Issue Brief

    As the coronavirus continues to spread, the number of people on Medicare admitted to the hospital for COVID-19 related illness is expected to rise. We analyze how much Medicare beneficiaries could pay out-of-pocket for an inpatient hospital admission under traditional Medicare (assuming no supplemental coverage) or Medicare Advantage plans.

  • Medicare Part D in 2016 and Trends over Time

    Report

    This chartpack presents a summary of Part D enrollment, premiums, cost sharing, benefit design and other key trends in 2016 and changes over time. For 2016, the analysis finds that 40% of Part D enrollees are now in Medicare Advantage drug plans, and over half of all enrollees are in plans offered by just three firms. The chartpack also highlights some concerning trends in the Low-Income Subsidy market, with the fewest number of premium-free plans…

  • Snapshot of Where Hillary Clinton and Donald Trump Stand on Seven Health Care Issues

    Issue Brief

    Where do the 2016 Presidential candidates, Hillary Clinton and Donald Trump, stand on key health care issues? This snapshot outlines the candidates' positions and policy statements on issues such as health insurance, the ACA, Medicaid, Medicare, the opioid epidemic, prescription drug costs, women's reproductive health, and Zika.

  • Few People Switch Medicare Advantage Plans Each Year, Raising Questions About Whether Seniors Have the Tools and Information They Need To Compare Plans  

    News Release

    A small share of Medicare Advantage enrollees switch plans each year, but those who do tend to pick plans with lower premiums and out-of-pocket limits than the plans they left behind, according to a new analysis by the Kaiser Family Foundation. Eleven percent of enrollees voluntarily switched from one Medicare Advantage plan to another between 2013 and 2014, the analysis finds, while another four percent were forced to change because their Medicare Advantage plan exited…