Medicare

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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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  • Dental, Hearing, and Vision Costs and Coverage Among Medicare Beneficiaries in Traditional Medicare and Medicare Advantage

    Issue Brief

    This analysis builds on our prior work – Medicare and Dental Coverage: A Closer Look – by analyzing hearing and vision use, out-of-pocket spending and cost-related barriers to care among Medicare beneficiaries as well as hearing and vision benefits in Medicare Advantage plans. It also incorporates top-level findings from the analysis of dental services to provide a comprehensive profile of dental, hearing, and vision benefits in Medicare.

  • Key Facts About Medicare Part D Enrollment and Costs in 2022

    Issue Brief

    This analysis provides the latest data about Medicare Part D enrollment, premiums, and cost sharing in 2022 and trends over time, including information about stand-alone prescription drug plans (PDPs) and Medicare Advantage prescription drug plans.

  • Simulating the Impact of the Drug Price Negotiation Proposal in the Build Back Better Act

    Issue Brief

    The Build Back Better Act (BBBA) includes a range of health and other proposals supported by President Biden, including a proposal to allow the federal government to negotiate the price of some prescription drugs covered under Medicare Part B (administered by physicians) and Medicare Part D (retail outpatient drugs). This brief illustrates the potential scope of the drug price negotiation proposal in the BBBA. This analysis is designed to highlight the types of Medicare-covered drugs…

  • Medicare Consumer-Directed Health Plan: Medicare MSAs and HSA-like Plans in 2007

    Issue Brief

    Medicare Consumer-Directed Health Plan: Medicare MSAs and HSA-like Plans in 2007 This March 2007 issue brief, commissioned by the Kaiser Family Foundation, examines the development of consumer-directed health plans in the Medicare program. Medicare Medical Savings Account plans have high deductibles accompanied by a personal savings account that can be used to pay for medical expenses. The paper examines how such plans operate in Medicare, how they differ from other types of Medicare Advantage plans…

  • Proposed Models to Integrate Medicare and Medicaid Benefits for Dual Eligibles: A Look at the 15 State Design Contracts Funded By CMS

    Issue Brief

    This brief summarizes 15 states' preliminary proposals to better coordinate care for people who are in both the Medicare and Medicaid programs. The design contracts, funded by the federal Center for Medicare and Medicaid Innovation (CMMI), are an outgrowth of new efforts under the health reform law to develop service delivery and payment models that integrate care for the nation’s nearly 9 million "dual eligibles," whose medical needs and health care costs typically exceed those…

  • Firm Perspectives on the Medicare Advantage Market

    Issue Brief

    Based on interviews with senior executives at 14 large firms, the issue brief finds that insurers anticipate continuing to offer Medicare Advantage plans in 2012, in part because of a Medicare demonstration project that will award bonus payments to plans based on their quality standards. A companion issue brief examines trends in Medicare Advantage enrollment in 2011. The analysis was conducted by researchers at Mathematica Policy Research, Inc. and the Kaiser Family Foundation. Issue Brief…

  • Medicare Part D 2009 Data Spotlight: Premiums

    Report

    This Medicare Part D data spotlight analyzes the premiums charged by the 1,689 stand-alone Medicare Part D plans that will be offered in markets across the country in 2009. The analysis finds premiums charged for Part D plans range widely, from $10.30 per month to $136.80 per month. If current enrollees remain in their current plan for next year, the weighted average monthly premium for PDPs would increase by $7.40 per month, from $29.89 in…

  • Medicare Advantage in 2008

    Issue Brief

    Medicare Advantage plans enrolled a record 9.8 million beneficiaries, more than one in five of the nation’s 44 million people on Medicare as of April 2008. That represents an increase of more than 800,000 beneficiaries in just four months, continuing a period of unprecedented growth for private plans in Medicare since 2003. This issue brief, prepared for the Kaiser Family Foundation by Marsha Gold of Mathematica Policy Research, Inc., analyzes recent developments in the Medicare…