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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 Incomes, Little Savings: Many Medicare Beneficiaries Have Modest Financial Resources to Draw Upon in Retirement 

    News Release

    A new KFF analysis shows that most Medicare beneficiaries live on relatively low incomes and have modest financial resources for retirement – posing a risk to their economic well-being, particularly if they were to have a major, unanticipated expense, such as a need for long-term nursing home care. The financial picture is especially bleak among Black and Hispanic Medicare beneficiaries, who tend to have lower incomes, savings, and home equity than White beneficiaries, the analysis…

  • Nearly 7 in 10 Medicare Beneficiaries Did Not Compare Plans During Medicare’s Open Enrollment Period

    Issue Brief

    This brief examines the share of Medicare beneficiaries who reviewed their coverage and compared plans during the open enrollment period for 2022 (that takes place in the Fall of 2021), and who made use of Medicare’s official information resources, as well as variations by demographic groups. Overall, nearly 7 in 10 Medicare beneficiaries did not compare their own source of Medicare coverage with other Medicare options offered in their area.

  • Nearly 7 in 10 Medicare Beneficiaries Do Not Compare Coverage Options During Open Enrollment  

    News Release

    With open enrollment less than a month away, a new KFF analysis suggests that the vast majority of the nation’s 67 million Medicare beneficiaries will not shop around among the coverage options for 2025 or switch plans. It’s a decision that could have a significant impact on enrollees’ coverage and costs. The analysis of federal data shows that nearly 7 in 10 Medicare beneficiaries (69%) did not  compare their Medicare coverage with other Medicare options…

  • The COVID-19 Pandemic Has Hit People of Color the Hardest, Including Among People With Medicare

    News Release

    The COVID-19 pandemic has underscored the stark racial and ethnic health inequities in the U.S., including among Medicare beneficiaries. Among this group, people of color, including older adults and others on Medicare, account for disproportionate shares of COVID-19 cases, hospitalizations and deaths, according to data presented in a new KFF report about racial and ethnic disparities in health among people with Medicare. Older Black, Hispanic, and American Indian/Alaska Native adults were nearly twice as likely…

  • Is the End of the Long-Term Care Crisis Within Sight? New COVID-19 Cases and Deaths in Long-Term Care Facilities Are Dropping

    Policy Watch

    This analysis compares trends in new COVID-19 cases and deaths among nursing facility residents with trends in all other new COVID-19 cases and deaths excluding nursing facility residents through February 7, 2021. This analysis shows a marked divergence in new cases and deaths per week between nursing facility residents and the rest of the US population since December 2020. This drop in new deaths and cases in nursing facility residents coincides with the start of…

  • Medicaid-Related Provisions in the Ticket to Work and Work Incentives Improvement Act of 1999

    Report

    In December, the President signed into law the Ticket to Work and Work Incentives Improvement Act of 1999, which includes provisions that will give states additional options for extending Medicaid coverage to working disabled individuals. This memo presents an overview of the eligibility options offered under the new legislation (Publication #2187). A related publication, Medicaid Eligiblity for Individuals with Disabilities (Publication #2150), provides a general overview of federal Medicaid eligibility policy for the low-income disabled…

  • Targeting Medicare Drug Benefits: Costs and Issues

    Report

    This report, written by Marilyn Moon and Matthew Storeygard of the Urban Institute, estimates the potential cost of targeting drug benefits to low-income Medicare beneficiaries and those with catastrophic drug expenses and discusses some of the key programmatic issues that could arise under this approach. The authors predict that a targeted and comprehensive drug benefit would likely help more than half of the 11.3 million low-income beneficiaries who lack drug coverage through Medicaid or an…

  • Medicaid Managed Care for Persons With Disabilities: State Profiles-2114

    Report

    Medicaid Managed Care for Persons With Disabilities: State Profiles This report provides state estimates of the number of Medicaid disabled enrolled in managed care and profiles these programs. It provides detailed comparative state information on enrollment, program features, rate setting, quality issues, and special enrollment features for the disabled in Medicaid managed care. It also highlights individual state profiles on the Medicaid managed care programs that include persons with disabilities. Report

  • The Basics of Medicare and Medicaid

    Issue Brief

    Together, Medicare and Medicaid provide health coverage to about 90 million Americans. To help explain the two programs, the Kaiser Family Foundation issued a new primer on the Medicare program and an updated version of its primer on the Medicaid program. Prepared by Kaiser staff, the primers provide an overview of the programs, who they serve, how the programs work and how they are financed. Medicare: A Primer Medicaid: A Primer