Medicare

NEW AND NOTEWORTHY

Examining the Potential Impact of Medicare’s New WISeR Model

A federal initiative to establish new prior authorization requirements in traditional Medicare, called the Wasteful and Inappropriate Service Reduction (WISeR) model, is likely to have only modest impact in its first year.

State Profiles for Dual-Eligible Individuals

This data collection draws on Medicare and Medicaid administrative data to present national and state-level information on people who are covered by both Medicare and Medicaid, referred to as dual-eligible individuals (also known as dually-enrolled beneficiaries).

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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  • Changes to the Medicare Advantage Program Enhance Some Consumer Protections But Roll Back Others

    Issue Brief

    CMS recently finalized policies as part of the 2027 Medicare Advantage final rule that both enhance consumer protections and roll back changes to the Medicare Advantage program that were intended to protect consumers. These changes have gotten less attention than payment issues and changes to the star ratings system, which also affect plan payments, but could have implications for Medicare beneficiaries.

  • Serving Low-Income Families Through Premium Assistance: A Look At Recent State Activity

    Issue Brief

    This issue paper examines the policies in the HIFA waiver initiative that provide incentives for states to use Medicaid/SCHIP funds to assist in the purchase of private insurance options. It also reports on how states have responded to these new policies and what key policy questions are raised about premium assistance programs. Issue Paper (.pdf)

  • Medicare 101: What You Need to Know

    Event Date:
    Event

    The Alliance for Health Reform and the Kaiser Family Foundation present a briefing to discuss the basics of Medicare, its role in the health care system, and how the program has evolved over time. Speakers address questions on how the program is administered, how much it costs and how it is financed. A short video produced by the Kaiser Family Foundation, "The History of Medicare: A Timeline," will be shown at the event. For more…

  • Access To Health Care:

    Report

    Promises and Prospects For Low-Income Americans This book explores critical issues affecting access to health care for low-income Americans by assessing the importance of expansions of health coverage for the poor, the emerging challenges providers who serve low-income and uninsured populations face in a rapidly evolving health care delivery system, and the effects of these changes on particularly vulnerable populations. Articles include: IntroductionMarsha Lillie-Blanton, Rose Marie Martinez, Barbara Lyons, Diane Rowland A Review Of The…

  • Medicaid and the Elderly

    Other Post

    Long-Term Care Spending In 1993, Medicaid spent $25.5 billion for long-term care services for elderly beneficiaries (Figure 5). This represents 58 percent of the $44 billion Medicaid spent on long-term care services for all population groups. The majority of spending was for care delivered in nursing facilities (84 percent) and ICFs-MR (2 percent). The remaining 14 percent of Medicaid long-term care spending went towards community-based care, including 3 percent for mental health services and 11…