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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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  • Medicare Advantage 2012 Spotlight: Plan Availability and Premiums

    Report

    This brief highlights trends in the Medicare Advantage marketplace, including the choices available to Medicare beneficiaries in 2012, premium levels and other plan characteristics. The brief was authored by researchers at Mathematica Policy Research and the Kaiser Family Foundation. Data Spotlight (.pdf)

  • Medicare Part D 2012 Data Spotlights

    Report

    The Kaiser Family Foundation has issued this collection of analyses related to the Medicare Part D stand-alone drug plan options available to seniors in 2012. These spotlights focuses on key aspects of the drug plan choices available and relevant trends since the Medicare drug benefit took effect in 2006. They were prepared by a team of researchers at Georgetown University, NORC at the University of Chicago and the Kaiser Family Foundation. Analysis Of Medicare Prescription…

  • Oversight and Enforcement of Medicare Part D Plan Requirements:  Federal Role and Responsibilities

    Issue Brief

    Oversight and Enforcement of Medicare Part D Plan Requirements: Federal Role and Responsibilities This Issue Brief was commissioned by the Kaiser Family Foundation to gain insights into legal advocates’ views of how federal authorities enforce compliance with requirements of the new Medicare Part D prescription drug benefit. The report was prepared by Toby Edelman of the Center for Medicare Advocacy, Inc. The views expressed in this report are those of the author and not necessarily…

  • Implications of the New Medicare Law for Dual Eligibles:  10 Key Questions and Answers

    Issue Brief

    Implications of the New Medicare Law for Dual Eligibles: 10 Key Questions and Answers This publication is designed to provide a more detailed explanation of the change in drug coverage policy for dual eligibles under the new Medicare law, as well as explore its implications for the individuals affected by it. Issue Paper (.pdf)

  • Medicare Advantage Plan Star Ratings and Bonus Payments in 2012

    Report

    This report looks at the star ratings that have been used for many years to help consumers compare plans, and examines how Medicare Advantage quality scores will interact with plan payments, beginning in 2012. To encourage Medicare Advantage plans to provide quality care, the 2010 health reform law authorized Medicare to pay plans bonuses beginning in 2012 if they receive four or five stars on the program’s five-star quality rating system, or are unrated. Building…

  • Prescription Drug Procurement and the Federal Budget

    Issue Brief

    This brief commissioned by the Foundation considers areas where Medicare faces limited opportunity for market-based competition and price negotiation to drive down drug spending. These areas include drug purchasing for low-income people enrolled in Part D plans who face minimal cost-sharing requirements, and purchasing certain unique drugs, such as biologicals, that have no therapeutic alternatives or competitors. Authored by Richard G. Frank of Harvard University, the brief discusses policy options that could lower Medicare spending…

  • Medicare Part D 2008 Data Spotlight: Benefit Design

    Issue Brief

    This Medicare Part D data spotlight examines the benefit design of Medicare Part D Prescription Drug Plans (PDP) in 2008, focusing on national plans. It shows that in 2008, as in previous years, only about 10 percent of national prescription drug plans offered the defined standard benefit. The spotlight also looks at cost sharing structures, the use of flat dollar copayments, the upward trend in cost sharing for non-preferred drugs, and recent changes in cost…