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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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  • Dual Eligibles: Medicaid Enrollment and Spending for Medicare Beneficiaries in 2003

    Issue Brief

    Dual Eligibles: Medicaid Enrollment and Spending for Medicare Beneficiaries in 2003 This report provides the latest national and state data on Medicaid enrollment and spending for individuals enrolled in both Medicaid and Medicare, also knows as dual eligibles. Nationally, there are 7.5 million dual eligibles and while they comprise 14 percent of the Medicaid population, they account for 40 percent of Medicaid spending. Issue Paper (.pdf)

  • Tracking Prescription Drug Coverage Under Medicare:  Five Ways to Look at the New Enrollment Numbers

    Issue Brief

    Tracking Prescription Drug Coverage Under Medicare: Five Ways to Look at the New Enrollment Numbers This new analysis, which assesses Medicare drug benefit enrollment statistics released Feb. 22 by the U.S. Department of Health and Human Services, examines five different approaches to understanding the Medicare drug coverage numbers: What share of the total Medicare population has creditable prescription drug coverage? What share of the total Medicare population is enrolled in a Medicare drug plan? How…

  • Medicare Part D 2008 Data Spotlight: Low-Income Subsidy Plan Availability

    Issue Brief

    This Medicare Part D Data Spotlight focuses on the availability of drug plans for beneficiaries receiving the Part D low-income subsidy in 2008 and changes since 2006. It looks at data from the 47 stand-alone prescription drug plans available nationwide in 2008. This is one in a series analyzing key aspects of the 2008 Medicare Part D prescription drug plan choices. The analysis was conducted jointed by Jack Hoadley of Georgetown University, Elizabeth Hargrave of NORC…

  • Risk Selection Issues Under Medicare Reform Proposals

    Report

    This report compares the provisions designed to guard against risk selection among the Medicare population in both the Congressional Balanced Budget Act of 1995 and in the President's budget plan released in December 1995. The report also explores provisions in both that may exacerbate the potential for risk selection. Report:

  • The Value of Extra Benefits Offered by Medicare Advantage Plans in 2006

    Report

    The Value of Extra Benefits Offered by Medicare Advantage Plans in 2006 As Medicare Advantage enrollment continues to climb, this report prepared for the Kaiser Family Foundation compares the value of extra benefits provided by private fee-for-service and other types of Medicare Advantage plans. As of January 2008, 8.8 million people with Medicare were enrolled in a Medicare Advantage plan, an increase of 63% since 2005. Some say the recent growth in Medicare Advantage enrollment…

  • Medicare and the President’s Fiscal Year 2009 Budget Proposal

    Fact Sheet

    Medicare and the President's Fiscal Year 2009 Budget Proposal This fact sheet summarizes key Medicare-related provisions in the Bush Administration's fiscal year 2009 budget proposal, as well as additional legislation that responds to the Medicare Trustees' "Medicare Funding Warning." Fact Sheet (.pdf)

  • The Role of Private Plans in Medicare

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    Event

    Enrollment in private health plans has grown sharply since the enactment of the Medicare Modernization Act in 2003, which created a Medicare drug benefit to be provided by private plans and created incentives for new private plans to enter the Medicare market. Today, virtually all Medicare beneficiaries--including those living in rural areas--have access to one or more private plans (known as Medicare Advantage plans), such as a Medicare HMO, PPO, special-needs plan or a private…

  • Medicaid Matters For Low Income Medicare Beneficiaries: A Video

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    In this video, Mildred Benham, a 68 year-old dual enrollee who lives in Bloomington, Illinois, describes the role Medicaid plays in providing services that Medicare does not, such as prescription drugs and personal care. Mildred is a typical dual enrollee in that she has multiple conditions, such as fibrosis of the lungs, rheumatoid arthritis, high blood pressure, and cataracts. To control her conditions, she takes 12 prescriptions a day. Because of her physical limitations, Medicaid…