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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  • Analysis Examines the Affordable Care Act’s Impact on Nearly All Americans

    News Release

    A week after the 2020 elections, the Supreme Court is scheduled to hear arguments on a legal challenge, supported by the Trump administration, that seeks to overturn the Affordable Care Act, an outcome that would have major effects throughout the health care system as the law’s provisions have affected nearly all Americans in some way. A KFF analysis examines key provisions of the 2010 law that have changed the nation’s health care system, including what’s…

  • Women and Medicare:  Making the Connection

    Other Post

    Women and Medicare: Making the Connection This briefing examines Medicare s role in meeting older women's health needs, the gaps in Medicare's benefits package for women, and the emerging debate over prescription drug coverage and Medicare reform.

  • State Demonstrations to Integrate Care and Align Financing for Dual Eligible Beneficiaries: A Review of the 26 Proposals Submitted to CMS

    Report

    The Centers for Medicare and Medicaid Services (CMS) has proposed two models to align Medicare and Medicaid benefits and financing for dual eligible beneficiaries, one capitated model and one managed fee-for-service model. In the spring of 2012, 26 states submitted proposals to CMS seeking to test one or both of these models. CMS is presently reviewing the states' proposals to determine which will be implemented. This background paper examines the contents of the 26 states'…

  • 2025 Medicare Advantage Plan Choices are Stable, Following Years of Steady Growth

    Policy Watch

    A review of the 2025 Medicare Advantage plans available for individual enrollment shows that the total number of plans declined by 7% (from 3,959 to 3,699). The average Medicare beneficiary will have the option of 34 Medicare Advantage prescription drug (MA-PD) plans in 2025, just 2 fewer than the 36 options available in 2024. Since 2018, the number of plans available to the average beneficiary has doubled.

  • Medicare at 40

    Video

    The Kaiser Family Foundation has produced three documentaries to mark the 40th anniversary of Medicare and Medicaid. The documentaries examine the social needs that led policymakers to create these programs, the expectations of what they would achieve and the reality of these programs today. Key policymakers, staff officials and members of Congress involved in the creation and implementation of Medicare and Medicaid are interviewed. Extensive use of historic video helps tell the story of these…

  • The 4 Arguments You Will Hear Against Drug Price Negotiation

    Perspective

    As the Biden administration begins the process of negotiation drug prices for Medicare as authorized in the Inflation Reduction Act, KFF's Larry Levitt probes some of the arguments against it and the policy and political implications of the debate in this New York Times op-ed column.

  • Medicare Part D: A First Look at Medicare Drug Plans in 2023

    Issue Brief

    This issue brief provides an overview of the Medicare Part D marketplace in 2023 and key trends over time, focusing primarily on stand-alone Medicare drug plans, including plan availability, premiums, and cost sharing. The brief also describes the prescription drug provisions in the Inflation Reduction Act of 2022 that affect the Medicare Part D marketplace beginning in 2023

  • Medicare Advantage 2023 Spotlight: First Look

    Issue Brief

    For 2023, the average Medicare beneficiary has access to 43 Medicare Advantage plans and can choose from plans offered by nine firms. Among the majority of Medicare Advantage plans that cover prescription drugs, 66 percent will charge no premium in addition to the monthly Medicare Part B premium. As in previous years, the vast majority of Medicare Advantage plans will offer supplemental benefits, including fitness, dental, vision, and hearing benefits. In addition, virtually all will…

  • KFF News Release

    KFF Survey Shows Complexity, Red Tape, Denials, Confusion Rivals Affordability as a Problem for Insured Consumers, With Some Saying It Caused Them to Go Without or Delay Care

    News Release

    Most (58%) people with health insurance say they encountered at least one problem using their coverage in the past year, with even larger shares of people with the greatest health care needs reporting such problems, finds a new KFF survey of consumer experiences with health insurance. Such problems vary across types of insurance but include such things as denied claims for care they thought was covered, difficulty finding an in-network doctor or other provider, and…