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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  • Raising Medicare’s Eligibility Age: A Complex Proposition

    Event Date:
    Event

    The Alliance for Health Reform and the Kaiser Family Foundation present a briefing to discuss the complexities of raising the age for Medicare eligibility. Speakers address questions on how this proposed change may affect beneficiaries, employers, and the workforce, as well as the cost and coverage implications for those approaching the current age of eligibility or enrolled in Medicare today. For more information, please visit the Alliance's event page. Full Video Speakers for this session:…

  • The Role of Private Plans in Medicare

    Event Date:
    Event

    Enrollment in private health plans has grown sharply since the enactment of the Medicare Modernization Act in 2003, which created a Medicare drug benefit to be provided by private plans and created incentives for new private plans to enter the Medicare market. Today, virtually all Medicare beneficiaries--including those living in rural areas--have access to one or more private plans (known as Medicare Advantage plans), such as a Medicare HMO, PPO, special-needs plan or a private…

  • Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2025

    Issue Brief

    The Medicare Part D program provides an outpatient prescription drug benefit to more than 50 million older adults and people with long-term disabilities in Medicare who enroll in private plans, including stand-alone prescription drug plans (PDPs) to supplement traditional Medicare and Medicare Advantage prescription drug plans (MA-PDs) that include drug coverage and other Medicare-covered benefits. This brief analyzes Medicare Part D enrollment and costs in 2025 and trends over time, based on data from the…

  • The Bigger Story, and Agenda, Behind GOP Changes to Obamacare, Medicare and Medicaid

    From Drew Altman

    This column was published as a Wall Street Journal Think Tank column on November 21, 2016. Early media coverage of the Republican health-care agenda has concentrated on plans to repeal and then replace the Affordable Care Act. The larger story is GOP preparations for a health policy trifecta: to fundamentally change the ACA, Medicaid and Medicare–all three of health care’s major programs–and in the process, fundamentally alter the direction of the federal role in health and core elements…

  • The Role of State Pharmaceutical Assistance Programs in Serving Low-Income Medicare Beneficiaries Following the Implementation of Medicare Part D

    Issue Brief

    The Role of State Pharmaceutical Assistance Programs in Serving Low-Income Medicare Beneficiaries Following the Implementation of Medicare Part D Prior to January 1, 2006, State Pharmaceutical Assistance Programs helped to fill a critical gap in coverage for Medicare beneficiaries without prescription drug coverage, targeting resources to beneficiaries with relatively low incomes. With the inception of the Medicare prescription drug benefit, the role of SPAPs began to change. This policy brief examines the role of state…

  • State Demonstrations to Integrate Care and Align Financing for Dual Eligible Beneficiaries: A Review of the 26 Proposals Submitted to CMS

    Report

    The Centers for Medicare and Medicaid Services (CMS) has proposed two models to align Medicare and Medicaid benefits and financing for dual eligible beneficiaries, one capitated model and one managed fee-for-service model. In the spring of 2012, 26 states submitted proposals to CMS seeking to test one or both of these models. CMS is presently reviewing the states' proposals to determine which will be implemented. This background paper examines the contents of the 26 states'…