Medicare

NEW AND NOTEWORTHY

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.

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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  • Two KFF Analyses Explore the Demographics of People Jointly Enrolled in Medicare and Medicaid As Well As Program Enrollment and Spending for This Population

    News Release

    The 12.5 million people who are jointly enrolled in Medicare and Medicaid include some of the poorest individuals in the U.S. with some of the highest health needs, requiring disproportionately high spending from both programs to support them. Two new KFF analyses examine the demographics of this population as well as the latest data on program enrollment and spending.  These data can help inform federal and state policy discussions about ways to improve coordination and…

  • Enrollment and Spending Patterns Among Medicare-Medicaid Enrollees (Dual Eligibles)

    Issue Brief

    This brief examines national and state-level data on enrollment and spending for Medicare-Medicaid enrollees using the 2019 and 2020 Medicare Beneficiary Summary Files and the 2019 Transformed Medicaid Statistical Information System (T-MSIS). Spending data for Medicare includes beneficiaries in traditional Medicare only, since spending data for beneficiaries enrolled in Medicare Advantage plans are unavailable. State-level data on Medicare-Medicaid enrollment and spending are available through KFF’s State Health Facts.

  • A Profile of Medicare-Medicaid Enrollees (Dual Eligibles)

    Issue Brief

    This brief examines the demographic, socioeconomic, and health characteristics of Medicare-Medicaid enrollees using the 2020 Medicare Current Beneficiary Survey. It highlights the diversity within the Medicare-Medicaid population and how Medicare-Medicaid enrollees differ from all other Medicare beneficiaries.

  • Explaining the Prescription Drug Provisions in the Inflation Reduction Act

    Issue Brief

    The Inflation Reduction Act includes several provisions that will lower prescription drug costs for people with Medicare and reduce drug spending by the federal government. This brief summarizes these provisions and discusses the expected effects on people, program spending, and drug prices and innovation.

  • What to Know about Medicare Spending and Financing

    Issue Brief

    This brief provides an overview of Medicare spending and financing, based on the most recent historical and projected data from the Medicare Trustees and the Congressional Budget Office (CBO). The brief highlights trends in Medicare spending and key drivers of spending growth, including higher enrollment, growth in health care costs, and increases in payments to Medicare Advantage plans.

  • The Small Share of Employers Offering Retiree Health Benefits Are Increasingly Turning to Medicare Advantage

    News Release

    Few employers offer retiree health benefits, and those that do increasingly are turning to Medicare Advantage plans to provide that coverage – a shift that has implications both for retirees and for federal spending, finds a new KFF analysis. Among the relatively small share of large firms (200 or more workers) that offer retiree health benefits to Medicare-age retirees, half (50%) provide these benefits through a Medicare Advantage plan in 2022, according to the analysis…

  • The Typical Medicare Beneficiary Has Close to 70 Different Medicare Advantage and Medicare Part D Stand-Alone Plan Options for 2023

    Feature

    The Medicare open enrollment period that runs from October 15 to December 7 each year is an opportunity for Medicare beneficiaries in traditional Medicare and Medicare Advantage to evaluate their current coverage, compare plans, and decide whether to make a change for the coming year. Beneficiaries can compare Medicare Advantage plans, mainly HMOs and PPOs, which provide all Medicare-covered benefits, typically including Part D drug coverage, and may offer other benefits such as vision, dental,…