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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  • Health Provisions in the 2025 Federal Budget Reconciliation Law

    Issue Brief

    On July 4, President Trump signed the budget reconciliation bill, previously known as the “One Big Beautiful Bill Act,” into law. This summary provides background, description, budgetary impact and related information on the health care provisions of the law in four categories: Medicaid, the Affordable Care Act, Medicare and Health Savings Accounts (HSAs).

  • Income-Relating Medicare Part B and Part D Premiums: How Many Medicare Beneficiaries Will Be Affected?

    Issue Brief

    Income-Relating Medicare Part B and Part D Premiums: How Many Medicare Beneficiaries Will Be Affected? New in February 2012: Brief Examines Proposals to Further Expand Medicare's Income-Related Premiums This new analysis from the Kaiser Family Foundation examines the number of Medicare beneficiaries who will pay higher Part B or Part D premiums as a result of newly enacted provisions included the 2010 health reform law. Part B Premiums. The health reform law modifies a requirement…

  • Do We Know If Medicare Advantage Special Needs Plans Are Special?

    Report

    This report describes the history of special needs plans, how they fit into the larger Medicare Advantage marketplace, and what information could help assess whether these plans are performing differently from other Medicare Advantage plans. Special needs plans serve individuals such as those who are institutionalized, people covered under both Medicare and Medicaid, or those with chronic or disabling conditions. Enrollment in these plans doubled in the past year, and President Bush recently signed the…

  • Medicare 101: What You Need To Know

    Event Date:
    Event

    Hosted by the Kaiser Family Foundation and the Alliance for Health Reform, this briefing reviewed basic questions about the Medicare program, such as: What services does Medicare provide, and how does Medicare pay for these services? How is Medicare financed? What changes did the Affordable Care Act (ACA) make to Medicare? How fast is Medicare spending growing? What are current proposals to strengthen Medicare for the future, and what are prospects for action in the…

  • Medicare’s Drug Benefit Is Firmly-Established After Its First Decade, With Flat Premiums in Recent Years but Higher Cost-Sharing Over Time 

    News Release

    With Medicare Part D nearing the end of its tenth year, the program -- which now provides drug coverage to 72 percent of all Medicare beneficiaries -- has experienced no growth in average premiums in recent years but some notable increases in cost-sharing, according to a new report from the Kaiser Family Foundation. At a time of heightened public concern about the cost of prescription drugs, the report, Medicare Part D at Ten Years: The…

  • CMS’s Decision to End Temporary Subsidies to Medicare’s Stand-Alone Drug Plans Could Mean Larger Premium Increases for Some Beneficiaries Next Year

    Quick Insights

    Without these extra subsidies in place for 2027, some Part D stand-alone drug plan (PDP) enrollees could see a larger premium increase for drug coverage next year than they’ve faced in recent years, though plan-specific premium amounts are not yet known. While some policymakers questioned the rationale for and cost of the premium stabilization demonstration, which totaled $9.8 billion in 2025 and 2026, the extra subsidies worked as intended to stabilize year-over-year PDP premium increases…

  • 10 Things to Know About Medicare Advantage Dual-Eligible Special Needs Plans (D-SNPs)

    Issue Brief

    In 2023, 5.2 million dual-eligible individuals were enrolled in a Medicare Advantage plan designed specifically for dual-eligible individuals, known as Dual-Eligible Special Needs Plans (D-SNPs). This brief highlights 10 things to know about D-SNPs, including national and state enrollment trends, plan availability, insurer participation, benefits, and prior authorization rates and denials