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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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  • Health Issues in the 2000 Presidential Election

    Other Post

    A Comparison of Proposals This report presents basic, nonpartisan information to help readers compare the leading presidential candidates' proposals on health care issues, including health coverage for the uninsured, managed care and patients' rights, Medicare reform, prescription drug coverage for seniors, and long-term care. Part of a joint effort of the League of Women Voters and the Kaiser Family Foundation to educate and engage the public on key health policy issues, this side-by-side comparison is…

  • Strategies for Simplifying the Medicare Advantage Market

    Other Post

    Most Medicare beneficiaries have at least 40 Medicare Advantage (MA) plan options to choose from this year. While some favor a robust marketplace, others argue that fewer plan offerings, or more transparent differences across plans designs, would help beneficiaries choose plans most likely to meet their individual needs. While consumers generally show interest in choice and economists see it as enhancing value, research shows that individuals faced with a large number of alternatives often avoid…

  • Prescription Drug Sources Among Medicare Beneficiaries

    Report

    Note: Estimates are rounded to the nearest whole number, therefore do not sum to total. (1) Includes Veterans Administration, Indian Health Service, employer plans without retiree subsidies, employer plans for active workers, and state pharmaceutical assistance programs. (2) Includes employer/union, FEHB, and TRICARE coverage. (3) Approximately 0.5 million dual eligibles are enrolled in Medicare Advantage drug plans and are reported in this category. Source: HHS, January 30, 2007. Data as of January 16, 2007.

  • Private Fee-For-Service Plans In Medicare: Rapid Growth and Future Implications

    Event

    Kaiser Family Foundation Vice President Patricia Neuman, Ph.D., testified May 2007 before the House Ways and Means Subcommittee on Health on the rapid growth of private fee-for-service plans in the Medicare program and its implications for seniors and people with disabilities. Dr. Neuman is director of the Foundation's Medicare Policy Project. Testimony (.pdf)

  • An Update on CMS’s Capitated Financial Alignment Demonstration Model For Medicare-Medicaid Enrollees

    Issue Brief

    Beginning in January, 2013, the Centers for Medicare and Medicaid Services (CMS) will implement a three year multi-state demonstration to test new service delivery and payment models for people dually eligible for Medicare and Medicaid. These demonstrations will enroll full dual eligibles in managed fee-for-service or capitated managed care plans that seek to integrate benefits and align financial incentives between the two programs. On January 25, 2012, CMS issued a memorandum providing additional guidance for…

  • Best Bets for Reducing Medicare Costs for Dual Eligible Beneficiaries: Assessing the Evidence

    Report

    With pressure mounting to slow the growth in federal health care spending, policymakers are exploring ways to reform the way care is delivered to the 9 million low-income Medicare beneficiaries who also receive Medicaid – a group that on average is sicker and frailer than other Medicare beneficiaries, and therefore receive significantly more care at greater cost. Major efforts are underway at the federal and state level to better coordinate care for this population and…

  • Selected Findings on Knowledge and Understanding of the New Medicare Rx Drug Program — March/April 2004 Kaiser Health Poll Report Survey

    Poll Finding

    Selected findings from the March/April 2004 Kaiser Family Foundation Health Poll Report survey underscores the need to educate seniors about the new Medicare prescription drug program - both the transitional discount card program that will be go into effect on June 1, 2004 and the full Medicare benefit that begins in January 2006. The survey, which is conducted every two months, is designed and analyzed by staff at the Foundation and colleagues at the Harvard…

  • ¿Cómo puedo averiguar si mi médico acepta Medicare?

    FAQs

    La mayoría de los médicos en los Estados Unidos aceptan Medicare. Para encontrar una lista de médicos en su área que reciben Medicare y aceptan no facturarle más del monto que Medicare aprueba por su visita, vaya al sitio web de Comparación de Médicos (Phsysician Compare) de Medicare y busque una marca de verificación junto a "pago aprobado" (Accepts Medicare Assignment). Si no tiene acceso a una computadora, también puede llamar al 1-800-MEDICARE (1-800-633-4227), o…

  • Key Facts About Medicare Part D Enrollment, Premiums, and Cost Sharing in 2021

    Issue Brief

    The Medicare Part D program provides an outpatient prescription drug benefit to older adults and people with long-term disabilities in Medicare who enroll in private plans, including stand-alone drug plans and Medicare Advantage drug plans. This analysis provides the latest data about Part D enrollment, premiums, and cost sharing in 2021 and trends over time.