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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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  • Probing the Legal Arguments in the Drug Industry’s Challenges to Medicare Drug Price Negotiations

    Event Date:
    Event

    With the Biden administration’s announcement of the first 10 drugs to be negotiated for Medicare as part of the Inflation Reduction Act (IRA), an array of legal challenges from the pharmaceutical industry is potentially the biggest obstacle to implementation. On Tuesday, September 12, two legal experts and a health policy expert joined Larry Levitt, executive vice president for health policy at KFF, for a 45-minute discussion about the legal issues underpinning these lawsuits and how…

  • Women’s Health Data Book: A Profile of Women’s Health in the United States

    Fact Sheet

    The Women's Health Data Book: A Profile of Women's Health in the United States, offers the latest data and trends on the wide range of health issues that affect women across their life spans. Published by the Kaiser Family Foundation and the Jacobs Institute of Women's Health, the Data Book is edited by Dawn Misra, Ph.D. This book addresses social and economic factors and provides up-to-date information on chronic conditions, reproductive health, mental health, violence,…

  • How Medicare Advantage Rebates Disadvantage Medicare’s Stand-Alone Drug Plan Market

    Issue Brief

    The private plans that offer the Medicare Part D benefit - stand-alone drug plans and Medicare Advantage drug plans - are increasingly are competing on uneven terms, in part because the payment system for Medicare Advantage plans enables them to lower Part D premiums or reduce Part D cost sharing, making drug coverage from Medicare Advantage plans appear considerably cheaper, or even premium-free, to the beneficiary. This brief discusses the growing instability of the Part…

  • Chartpack: Kaiser Health Tracking Poll — December 2009

    Poll Finding

    This document contains the chartpack from the December Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted December 7 through December 13, 2009, among a nationally representative random sample of 1,204 adults ages 18 and older. Telephone interviews conducted by landline (801) and cell phone (403, including 111 who had no landline telephone) were carried out in English and Spanish. The margin of…

  • Policy Options to Sustain Medicare for the Future

    Report

    With Medicare expected to be a key part of Washington’s ongoing debate about solutions to reduce the federal budget and national debt, this report serves as a compendium of policy options that may be discussed in upcoming budget debates. The report presents a wide array of options in several areas and lays out the possible implications of these options for Medicare beneficiaries, health care providers, and others, as well as estimates of potential savings, when…

  • 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…