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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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  • Webinar for Journalists: How the Affordable Care Act Affects Baby Boomers and Medicare Beneficiaries

    Event Date:
    Event

    As part of the "Covering Health Reform" series, this webinar focused on the major changes facing older people. The Foundation's Associate Director of the Program on Medicare Policy, Juliette Cubanski and Senior Fellow Karen Pollitz discussed how the Affordable Care Act impacts Medicare benefits and beneficiaries, as well as the ACA's role for baby boomers who are not yet 65 and eligible for Medicare.

  • Demonstrations to Improve the Coordination of Medicare and Medicaid for Dually Eligible Beneficiaries: What Prior Experience Did Health Plans and States Have with Capitated Arrangements?

    Report

    This report examines the Center for Medicare and Medicaid Services (CMS) financial alignment demonstration for beneficiaries dually eligible for Medicare and Medicaid, with a focus on the extent to which participating states and health plans have prior experience with capitated managed care arrangements under Medicare or Medicaid, and specifically for this population. Under these capitated financial alignment demonstrations, health plans contract with the state and CMS (a three-way contract) to provide both Medicare and Medicaid…

  • Selected Survey Findings of the Medicare Rx Drug Law – Survey Toplines

    Poll Finding

    Seniors are confused about the Medicare prescription drug law. Below are survey toplines of selected findings from the January/February 2004 Kaiser Health Poll Report survey. The findings show that while about two-thirds of seniors report following the debate closely, just 15% say they understand the new prescription drug law very well and seven in 10 don’t know that it passed and was signed into law. Survey Toplines (.pdf)

  • Federal Funding Under the Affordable Care Act

    Fact Sheet

    This fact sheet provides highlights from an analysis tracking the flow of federal Affordable Care Act funds to states as reporter in the Department of Health and Human Services grant database as well as periodic reports from HHS and the Internal Revenue Service. The analysis distinguishes between funds awarded to state and local governments (including state and local health departments and school districts) and private entities (including private employers, health centers, universities, and other community-based…

  • Medicare Part D 2008 Data Spotlight: Utilization Management

    Issue Brief

    This Medicare Part D data spotlight examines three common techniques used by Medicare stand-alone prescription drug plans in 2008 to manage enrollees’ use of formulary drugs, such as quantity limits, prior authorization, and step therapy rules. This is one in a series analyzing key aspects of the 2008 Medicare Part D prescription drug plan choices. It analyzes data from the 47 stand-alone prescription drug plans available nationwide using a sample of 169 commonly-used and high-cost…

  • Medicare Part D in 2018: The Latest on Enrollment, Premiums, and Cost Sharing

    Issue Brief

    This brief about the 2018 Medicare Part D marketplace analyzes the latest data on Medicare drug coverage and trends over time, including both stand-alone prescription drug plans and Medicare Advantage drug plans. The analysis focuses on enrollment, premiums, cost sharing, and the low-income subsidy.

  • Survey on Health Care

    Other Post

    NPR/Kaiser Family Foundation/Harvard Kennedy School of Government Survey on Health Care A survey by NPR, the Kaiser Family Foundation, and Harvard s Kennedy School of Government finds that many Americans have real problems when it comes to accessing and paying for health care, and even if they haven't yet faced a problem, many worry about getting and paying for care in the future. The survey also shows that, while people think helping seniors with the…

  • What to Know About Medicare Coverage of Telehealth

    Issue Brief

    Congress has repeatedly extended several pandemic-era flexibilities around Medicare coverage of telehealth, but with a few key exceptions most pandemic-era telehealth flexibilities remain temporary. This brief provides answers to key questions about the current scope of Medicare telehealth coverage, including both temporary and permanent changes adopted through legislation and regulation, and policy considerations that lie ahead.