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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  • Mental Health and Substance Use Disorder Coverage in Medicare Advantage Plans

    Issue Brief

    This brief describes the scope of mental health and substance use disorder benefits in Medicare Advantage plans, including extra benefits, cost sharing, and prior authorization and referral requirements, based on an analysis of the Centers for Medicare and Medicaid Services (CMS) Medicare Advantage plan benefit and enrollment files for 2022.

  • KFF Survey of Consumer Experiences with Health Insurance

    Poll Finding

    The survey finds nearly six in 10 people with health insurance experienced a problem using their insurance in the past year, with even larger shares reporting problems among people who are sick or who have mental health needs. It includes data for people with different types of coverage, including employer, Marketplace, Medicare and Medicaid, and also examines affordability issues and mental health access.

  • Medicare Advantage Enrollment, Plan Availability and Premiums in Rural Areas

    Issue Brief

    Medicare Advantage enrollment is lower, but has grown more rapidly in recent years in rural areas than in metropolitan areas. In 2023, nearly 40% of eligible Medicare beneficiaries in rural areas are in Medicare Advantage. Rural Medicare beneficiaries can choose from 27 Medicare Advantage plans on average and most are enrolled in a plan that charges no additional premium.

  • Marketing Medicare – How Health Insurers and Brokers Use TV Ads to Attract Enrollees

    Event Date:
    Event

    KFF held a web event on September 20, 2023 to discuss Medicare marketing practices in advance of the open enrollment period, which begins Oct. 15. As part of the event, KFF released a new analysis of television ads that aired during last year’s open enrollment season and share insights from focus groups with enrollees about their perceptions of the marketing efforts.

  • What to Know About the Older Americans Act and the Services it Provides to Older Adults

    Issue Brief

    The Trump administration is proposing a reorganization and staffing cuts at HHS that create uncertainty about the potential effects on older adults, who receive services authorized under the Older Americans Act. This brief provides an overview of programs and services provided under the Older Americans Act, the role played by the Administration for Community Living in administering these programs, and trends in program funding and service utilization by older adults.