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.

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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  • Medicare Part D: A First Look at Prescription Drug Plans in 2018

    Issue Brief

    This issue brief provides an overview of the 2018 Medicare Part D stand-alone prescription drug plan landscape, the largest segment of the Part D marketplace, It includes national and state-level data on plan availability, premiums, benefit design, cost sharing, information about premium-free plans for low-income beneficiaries, and information about the top ten Part D plans in 2018.

  • Medicare’s Income-Related Premiums Under Current Law and Proposed Changes

    Issue Brief

    Most people with Medicare pay the standard monthly premium for Part B and Part D coverage, which is set to cover 25 percent of Part B and Part D program costs, but a relatively small share of beneficiaries are required to pay higher premiums. This issue brief describes current requirements with respect to Medicare's Part B and Part D income-related premiums and proposed changes under House legislation being considered in November 2017.

  • Medicare Advantage 2017 Spotlight: Enrollment Market Update

    Issue Brief

    This Data Spotlight reviews national and state-level enrollment trends as of March 2017 and examines variation in enrollment by plan type and firm. It analyzes the most recent data on premiums, out-of-pocket limits, Part D cost-sharing for drugs, and plans’ quality ratings for Medicare Advantage enrollees.

  • How Much (More) Will Seniors Pay for a Doc Fix?

    Perspective

    In this Policy Insight, the Foundation’s Cristina Boccuti and Tricia Neuman examine how Congress’ effort to permanently stave off scheduled cuts in Medicare’s physician payments could affect what Medicare beneficiaries pay for their care -- both in premiums and in other potential changes -- to offset the cost of the Sustainable Growth Rate (SGR) “doc fix.”

  • Medicare’s Role in Health-Care Payment Reform

    From Drew Altman

    In this column for The Wall Street Journal's Think Tank, Drew Altman explores whether Secretary Burwell's announcement this week about Medicare's payment reform initiative is another sign that the public sector is becoming the engine driving payment and delivery reform.

  • The Ups and Downs of Medicare Part B Premiums: Frequently Asked Questions

    Issue Brief

    This brief examines how Medicare Part B premiums for many beneficiaries are affected by the annual cost-of-living adjustment (COLA) for Social Security benefits. Based on the most recent projections from the Medicare and Social Security Trustees, the brief examines the interactions between the two programs that resulted in some Medicare beneficiaries paying significantly higher Part B premiums in 2010 and 2011 when there was no Social Security COLA, followed by a drop in premiums in…