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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  • Low-Income Medicare Beneficiaries: How the House and Senate Prescription Drug Bills Address Their Drug Needs

    Report

    The House and Senate versions of a Medicare prescription drug bill treat the drug costs of those dually-eligible for Medicare and Medicaid and other low-income Medicare beneficiaries quite differently. The Kaiser Commission on Medicaid and the Uninsured cosponsored a policy briefing on the key issues in the two bills that would impact low-income beneficiaries and released a brief and background report on the topic. A Prescription Drug Benefit in Medicare: Implications for Medicaid and Low-Income…

  • Health Care and the 2004 Elections

    Other Post

    ** Update: For information on health care and the 2008 election, visit www.health08.org. ** Health care issues continue to be important for many Americans and a vital part of the policy debates in Washington and around the country. During an election season, candidates propose and debate their solutions for the pressing policy issues facing their constituents. The 2004 election season is no different and the Kaiser Family Foundation is issuing informational materials on some of…

  • State Variation in Medicaid Pharmacy Benefit Use Among Dual-Eligible Beneficiaries

    Report

    This study examines Medicaid pharmacy benefit use and spending among beneficiaries dually eligible for Medicare and Medicaid in 10 states by analyzing 1995 enrollment and claims data from a new 12-state database. The study finds that dual-eligibles are relatively high users of the Medicaid pharmacy benefit, with substantial variation in both drug use and spending among this population across the 10 study states. This variation appears to persist independent of beneficiaries' health status and is…

  • How Medicare Advantage Rebates Disadvantage Medicare’s Stand-Alone Drug Plan Market

    Issue Brief

    The private plans that offer the Medicare Part D benefit - stand-alone drug plans and Medicare Advantage drug plans - are increasingly are competing on uneven terms, in part because the payment system for Medicare Advantage plans enables them to lower Part D premiums or reduce Part D cost sharing, making drug coverage from Medicare Advantage plans appear considerably cheaper, or even premium-free, to the beneficiary. This brief discusses the growing instability of the Part…

  • Medicare Part D Enrollment, Premiums, and Cost Sharing in 2026

    Issue Brief

    The Medicare Part D program provides an outpatient prescription drug benefit to 56 million older adults and people with long-term disabilities in Medicare who enroll in private plans. This brief analyzes Medicare Part D enrollment, premiums, and cost sharing in 2026 and trends over time, based on data from the Centers for Medicare & Medicaid Services (CMS).

  • As Medicare’s Open Enrollment Nears, New Analyses Highlight Key Changes in Medicare Advantage and Part D Plans for 2015

    News Release

    With Medicare's 2015 open enrollment set to begin Oct. 15, two new analyses from the Kaiser Family Foundation find modest change in the total number of private Medicare Advantage plans available for 2015, and the fewest Part D prescription drug plans nationwide since the start of the drug benefit in 2006. As in previous years, changes in Medicare Advantage and Part D plan availability, premiums, cost-sharing and benefits could require some beneficiaries to find alternative…