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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  • Medigap May Be Elusive for Medicare Beneficiaries with Pre-Existing Conditions

    Issue Brief

    This issue brief analyzes federal and state guaranteed issue rules and how they impact beneficiaries’ access to Medigap, including the implications for Medicare beneficiaries with pre-existing conditions and those under age 65 with long-term disabilities. This brief also explores a recently finalized rule: Nondiscrimination in Health Programs and Activities regarding Section 1557 of the Affordable Care Act that may have implications for the Medigap market.

  • The Uncertain Future of Medicare’s Stand-Alone Prescription Drug Plan Market and Why It Matters

    Issue Brief

    This brief focuses on the stand-alone Medicare Part D prescription drug plan marketplace and its somewhat uncertain future, in light of recent trends in plan availability and the potential for another year of premium increases in 2026, in part depending on what the Trump administration decides to do with the temporary Part D premium stabilization demonstration. The brief explains why the stability of the PDP market matters, both for people in traditional Medicare who want…

  • 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

  • How Does the Benefit Value of Medicare Compare to the Benefit Value of Typical Large Employer Plans?: A 2012 Update

    Issue Brief

    This study compares the value of Medicare's fee-for-service benefits last year with the value of benefits in two large employer health plans -- a large health plan serving federal employees and a typical large employer Preferred Provider Organization (PPO) plan. For individuals ages 65 and older, the study finds that Medicare remains less generous on average than typical large employer health plans, even after recent improvements in the program's drug coverage. Overall, Medicare would cover…

  • Medicare Chart Book 2005

    Other Post

    This updated resource features more than 80 charts and tables with detailed information about the Medicare program and the 42 million seniors and younger people with disabilities who rely on the program for health insurance coverage. It covers a wide range of relevant data, including state-by-state information when available. Each section can be accessed individually, or the full chartbook can be downloaded in its entirety. Complete Medicare Chartbook 2005 (.pdf) Overview (.pdf) Section 1: Medicare…

  • Explaining the State Integrated Care and Financial Alignment Demonstrations for Dual Eligible Beneficiaries

    Issue Brief

    This paper provides an overview of the joint efforts of states and the Centers for Medicare and Medicaid Services (CMS) to develop more integrated ways of paying for and delivering health care to the 9 million people who are eligible for both the Medicare and Medicaid programs. Dual eligible beneficiaries comprise many of the poorest and sickest people covered by either program, and they account for a disproportionately large share of Medicare and Medicaid spending.…

  • e-Health and the Elderly: How Seniors Use the Internet for Health

    Poll Finding

    A national Kaiser Family Foundation survey of older Americans found that as the Internet becomes an increasingly important resource for informing decisions about health and health care options, less than a third (31%) of seniors (age 65 and older) have ever gone online, but that more than two-thirds (70%) of the next generation of seniors (50-64 year-olds) have done so. The differences among seniors and 50-64 year-olds are striking and indicate that online resources for…

  • 2008 Election Briefs

    Poll Finding

    Health care remains among the top three election issues voters want to hear the presidential candidates discuss. Kaiser's new series of election briefs frame the challenges the heath care system faces, provide basic facts, and offer questions to assess the presidential candidates' plans on key health policy issues. Check back for more issue briefs.  Eliminating Racial/Ethnic Disparities in Health Care: What are the Options  Health Care Costs and Election 2008  Women's Health and Election 2008…