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.

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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  • Seven Million People with Medicare Spend More Than 10% of Income on Part B Premiums – The Reconciliation Bill Could Drive the Number Higher

    Issue Brief

    People with low incomes and limited financial resources can qualify for the Medicare Savings Programs, through which state Medicaid programs provide financial assistance with Medicare premiums and cost sharing. However, provisions in the GOP’s budget reconciliation bill would make it harder for people to enroll in these programs. Many people with Medicare are facing a relatively high financial burden associated with paying Part B premiums, and the reconciliation bill could drive that number higher.

  • Medicare Advantage Insurers Deny Prior Authorization Requests for Post Acute Care at Substantially Higher Rates Than the Overall Denial Rate

    Policy Watch

    Two recent reports find that Medicare Advantage organizations deny prior authorization requests for long-term care hospital, inpatient rehabilitation hospital, and skilled nursing facility stays at higher rates than requests overall. When these decisions are appealed, they are frequently overturned, particularly for skilled nursing facility stays. This may cause delays for Medicare beneficiaries who are particularly vulnerable or have high care needs.

  • Digital Health Tools and Technologies: An Overview of CMS’ Recent Efforts to Expand Their Use in Medicare

    Issue Brief

    As an increasing share of older adults have adopted digital health technologies over the past several years, and with most expressing interest in using them to manage their health care, the Centers for Medicare & Medicaid Services (CMS) has introduced several initiatives to expand the use of digital health technologies in Medicare. This brief summarizes these initiatives and draws on data from various surveys, including KFF Tracking Polls from September 2025 and March 2026, to…

  • Medicare Chartbook, 2010

    Report

    This chartbook provides the most recent and reliable data available about the Medicare program and the 47 million seniors and younger people with disabilities who get health insurance coverage through the program. Topics covered include: Medicare beneficiaries; the program's benefits, utilization, and access to care; prescription drugs; the Medicare Advantage program; the role of Medicaid for Medicare beneficiaries; supplemental insurance coverage; out-of-pocket spending; and Medicare spending and financing. Printable Chartbook (.pdf)

  • The Future of Medicare Advantage: Are We on the Right Path?

    Event Date:
    Event

    This June 10 briefing looked at Medicare Advantage and changes affecting it, including revised calculations of payments from CMS, and the Affordable Care Act's reduced payments to Medicare Advantage plans. Speakers discussed how Medicare Advantage plans are expected to respond to payment changes; if quality bonus payments created significant changes in patient care or plan choices; and what implications could these decisions have on beneficiaries with regard to premiums, benefits and more.

  • Explaining Health Care Reform: How Do Health Care Costs Vary By Region?

    Issue Brief

    Although regional variations in health spending have been studied for decades, there is renewed focus on this issue because of the role of health care costs in health care reform and the potential source of funds if addressing cost variations can yield savings. This explainer examines what is known about regional variations in health care costs and their relationship to quality of care, and addresses key questions about their role in health reform. Issue Brief…

  • Prospects for Retiree Health Benefits as Medicare Drug Coverage Begins

    Poll Finding

    Findings from the Kaiser/Hewitt 2005 Survey on Retiree Health Benefits The 2005 Kaiser/Hewitt survey of large businesses that provide retiree health benefits to their workers assesses their responses to the new Medicare drug benefit in 2006, their plans for the future, and the way these changes affect retirees. It also looks at the rising costs and changing benefits of retiree health coverage overall in 2005. News Release Report Chartpack Materials from the December 7, 2005…

  • The Implications of Medicare Prescription Drug Proposals for Employers and Retirees

    Report

    This report examines the potential savings for employers who currently represent the largest source of drug coverage for seniors. The study finds substantial savings for large employers under comprehensive Medicare prescription drug proposals ranging from $5-8.5 billion in 2003 to $10-$15 billion in 2009. It also finds that the majority of large employers are likely to retain retiree coverage, as a supplement to a Medicare drug benefit. Report