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.

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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  • How are Seniors Choosing and Changing Health Insurance Plans?

    Report

    This report summarizes first-hand accounts of seniors’ Medicare private plan decision making strategies, based on focus groups conducted in four cities. Seniors found the initial plan selection process overwhelming due to the volume of information they received and their inability to organize it. Few used the government's online comparison tool, and those that did cite several shortcomings. Many relied on advice from sources they trust, including insurance agents, plan representatives, friends, family members, doctor's offices…

  • May 13 Briefing: How Well Are Seniors Making Choices Among Medicare’s Private Plans And Does It Matter?

    News Release

    The typical Medicare beneficiary this year has 18 private Medicare Advantage plans and 35 stand-alone Part D drug plan options to consider, in addition to traditional Medicare. Medicare encourages seniors to make informed decisions with respect to their health coverage options when they first become eligible for Medicare, and to review these options annually so they select coverage that best meet their needs. Yet research suggests only a small share of Medicare beneficiaries voluntarily switch…

  • Me inscribí en un plan independiente de la Parte D al principio del período de inscripción abierta de Medicare, pero luego cambié de opinión. ¿Puedo cambiarme a otro plan si el período de inscripción ab...

    FAQs

    Puede presentar una nueva solicitud para un plan diferente al que solicitó inicialmente durante el período de inscripción abierta de Medicare. Tenga en cuenta que la última solicitud de plan que presente antes de que finalice el período de inscripción abierta de Medicare el 7 de diciembre es la cobertura que entrará en vigor el 1 de enero del año siguiente.

  • Medicare Advantage 2016 Data Spotlight: Overview of Plan Changes

    Issue Brief

    This issue brief analyzes the number and variety of Medicare Advantage plan choices available to beneficiaries in 2016. It describes trends in number of Medicare Advantage plans, plan premiums, and plan quality ratings, including changes in prescription drug coverage and limits on out-of-pocket expenses. This spotlight is part of a series of spotlights tracking key changes in the Medicare Advantage program.

  • Medicare Advantage Hospital Networks: How Much Do They Vary?

    Report

    This report takes an in-depth look at Medicare Advantage plans’ hospital networks. The analysis draws upon data from 409 Medicare Advantage plans serving beneficiaries in 20 diverse counties that together accounted for about one in seven (14%) Medicare Advantage enrollees nationwide in 2015. The report examines the size and composition of plans’ hospital networks, the variation across counties, the inclusion of Academic Medical Centers and NCI-Designated Cancer Centers, and the relationship between network size and…

  • Traditional Medicare…Disadvantaged?

    Perspective

    In this new policy insight, Tricia Neuman examines current rules that may discourage seniors from switching from Medicare Advantage to traditional Medicare. The issue is explored through the lens of a 67-year-old beneficiary who faced difficult financial and health coverage choices in the aftermath of a serious biking accident.

  • Medicare Part D Spending Trends: Understanding Key Drivers and the Role of Competition

    Issue Brief

    This brief commissioned by the Foundation examines factors that contributed to Medicare's lower-than-expected spending on prescription drugs under the Medicare Part D drug benefit that started in 2006. Since its launch, Medicare has spent about 30 percent less on Part D benefits than the Congressional Budget Office originally projected. Some cite the program's design, with private plans competing for enrollment, as the driving factor in lower spending; others point to factors in the overall market…