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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  • Health Reform Implementation Timeline

    Interactive

    The health reform implementation timeline is an interactive tool designed to explain how and when the provisions of the Affordable Care Act will be implemented over the next several years.

  • The 4 Arguments You Will Hear Against Drug Price Negotiation

    Perspective

    As the Biden administration begins the process of negotiation drug prices for Medicare as authorized in the Inflation Reduction Act, KFF's Larry Levitt probes some of the arguments against it and the policy and political implications of the debate in this New York Times op-ed column.

  • Understanding the Health Provisions in the Inflation Reduction Act

    Other Post

    President Biden signed the Inflation Reduction Act of 2022 into law on August, 16, 2022. KFF has several analyses relevant to understanding the health provisions in the legislation, as well as their potential impact on people. Among other measures, the legislation for the first time requires the HHS Secretary to negotiate prices for some top-selling drugs covered in Medicare. It also requires drug companies to pay rebates if prices rise faster than inflation for drugs…

  • Medicare Part D: A First Look at Medicare Drug Plans in 2023

    Issue Brief

    This issue brief provides an overview of the Medicare Part D marketplace in 2023 and key trends over time, focusing primarily on stand-alone Medicare drug plans, including plan availability, premiums, and cost sharing. The brief also describes the prescription drug provisions in the Inflation Reduction Act of 2022 that affect the Medicare Part D marketplace beginning in 2023

  • Medicare Advantage 2023 Spotlight: First Look

    Issue Brief

    For 2023, the average Medicare beneficiary has access to 43 Medicare Advantage plans and can choose from plans offered by nine firms. Among the majority of Medicare Advantage plans that cover prescription drugs, 66 percent will charge no premium in addition to the monthly Medicare Part B premium. As in previous years, the vast majority of Medicare Advantage plans will offer supplemental benefits, including fitness, dental, vision, and hearing benefits. In addition, virtually all will…

  • KFF News Release

    KFF Survey Shows Complexity, Red Tape, Denials, Confusion Rivals Affordability as a Problem for Insured Consumers, With Some Saying It Caused Them to Go Without or Delay Care

    News Release

    Most (58%) people with health insurance say they encountered at least one problem using their coverage in the past year, with even larger shares of people with the greatest health care needs reporting such problems, finds a new KFF survey of consumer experiences with health insurance. Such problems vary across types of insurance but include such things as denied claims for care they thought was covered, difficulty finding an in-network doctor or other provider, and…

  • Analysis Estimates Up To 2 Million Uninsured People Could Require COVID-19 Hospitalization

    News Release

    Patients Could Still Be on the Hook for Outpatient Costs, Costs If They Test Negative, and Cost Sharing A new KFF analysis estimates that between 670,000 and 2 million uninsured people around the country eventually could be hospitalized with COVID-19, the respiratory disease caused by the novel coronavirus. Reimbursing hospitals for those treatments could cost between $13.9 billion and $41.8 billion. Trump administration has indicated that it plans to reimburse hospitals for the care of…

  • Reading the Stars: Nursing Home Quality Star Ratings, Nationally and by State

    Issue Brief

    This issue brief presents national and state-level analysis of nursing homes based on the Five-Star Quality Rating System, recently updated by the Centers for Medicare and Medicaid Services (CMS) to help consumers compare nursing homes when selecting one for themselves or their family members. The issue brief finds that more than one-third (36%) of the nation’s 15,500 nursing homes certified by Medicare or Medicaid received relatively low ratings of 1 or 2 stars (out of…