Medicare

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Decoding Medicare Advantage Coding Intensity

As officials scrutinize Medicare Advantage payments, this issue brief answers key questions about coding intensity, recent steps taken by CMS to address the impact of coding, the effects on Medicare beneficiaries, and other proposals to improve Medicare Advantage payment accuracy.

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. 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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291 - 300 of 1,606 Results

  • How Many People with Employer-Sponsored Insurance Use the Drugs Slated for Medicare Price Negotiations

    Issue Brief

    Among the 167 million people with employer-sponsored insurance in 2022, 3.4 million used at least one of the first 10 drugs identified for Medicare price negotiations, according to a new analysis. The most used drug for people with employer-sponsored health insurance was Jardiance, a drug used to treat diabetes and heart failure, which was taken by more than 911,000 enrollees. The analysis uses the Merative MarketScan 2022 commercial claims to estimate the number of enrollees…

  • Medicare Advantage Plans Denied a Larger Share of Prior Authorization Requests in 2022 Than in Prior Years

    News Release

    Medicare Advantage plans denied 3.4 million prior authorization requests for health care services in whole or in part in 2022, or 7.4% of the 46.2 million requests submitted on behalf of enrollees that year, according to a new KFF analysis of federal data. That was a higher share of denials than in recent years. The share of all prior authorization requests denied by Medicare Advantage plans increased from 5.7% in 2019, 5.6% in 2020 and…

  • Compare the Candidates on Health Care Policy

    Feature

    The side-by-side comparison tool provides a quick overview of former President Trump's and Vice President Harris' records, positions, public statements, and proposed policies on a range of key health care topics.

  • What to Know About Medicare Part D Premiums

    Issue Brief

    Changes to the Medicare Part D benefit in the Inflation Reduction Act will mean lower out-of-pocket costs for Part D enrollees but higher costs for Part D plans overall, leading to concerns about possible premium increases. These FAQs provide context for understanding Part D premiums in 2025 and changes in recent years, and describe actions the Centers for Medicare & Medicaid Services (CMS) is taking to mitigate potential premium increases.

  • What are the Consequences of Health Care Debt Among Older Adults?

    Issue Brief

    Health care debt is a widespread problem in the United States. Medicare offers coverage for a range of health care services, including hospitalizations, physician visits, prescription drugs, and post-acute care, but Medicare beneficiaries generally pay out-of-pocket for their monthly premiums and deductibles, cost-sharing for Medicare-covered services, and the cost of services not covered by Medicare. This data note examines findings from the KFF Health Care Debt Survey to assess the prevalence, sources and consequences of…

  • Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2024

    Issue Brief

    This brief analyzes 2024 Medicare Part D enrollment, premiums, and cost sharing. The analysis highlights the continued growth in Medicare Advantage enrollment in the Part D marketplace and substantially higher average monthly premiums for stand-alone Part D drug plan coverage. Changes to the Part D benefit included in the Inflation Reduction Act are helping to lower out-of-pocket costs for patients but could also contribute to higher-priced Part D coverage.

  • Supreme Court Decision Limiting the Authority of Federal Agencies Could Have Far-Reaching Impacts for Health Policy

    Issue Brief

    On June 28, 2024, the U.S. Supreme Court overturned a longstanding legal precedent that required federal courts to defer to reasonable agency interpretation when statutes are ambiguous. The decision will shift many policy decisions from federal agencies to federal judges, with implications for health policy that will reverberate for years to come. This issue brief examines the decision and assesses what’s ahead.

  • Unraveling the Mysteries of Biden vs. Trump on Health Care

    From Drew Altman

    In his latest column, KFF President and CEO Drew Altman unravels the differences between Trump and Biden on Medicare, abortion, drug costs and other health-related issues that KFF's new side-by-side candidate analysis examines. From the bird’s eye view, these differences amount to a fork in the road in direction on the role of the federal government in health and federal health spending.