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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  • Gaps in Medicare Advantage Data Remain Despite CMS Actions to Increase Transparency

    Issue Brief

    The Centers for Medicare and Medicaid Services has recently taken actions to increase transparency in Medicare Advantage, however substantial data gaps remain that limit the ability of policymakers and researchers to conduct oversight and assess the program's performance, and for Medicare beneficiaries to compare Medicare Advantage plans offered in their area.

  • The Vast Majority of Nursing Facilities Will Need to Hire More Staff to Comply with the Final Federal Rule When Fully Implemented, Unless They Qualify for an Exemption

    News Release

    Based on a new KFF analysis, fewer than 1 in 5 (19%) nursing facilities currently meet the minimum staffing standards set out in the final requirements of the federal rule released today by the Centers for Medicare and Medicaid Services (CMS). CMS adopted staffing standards that are similar to the staffing requirements in the rule proposed last year, which included minimum staff levels of 0.55 registered nurses and 2.45 nurse aide hours per resident day.…

  • 2025 Medicare Advantage Plan Choices are Stable, Following Years of Steady Growth

    Policy Watch

    A review of the 2025 Medicare Advantage plans available for individual enrollment shows that the total number of plans declined by 7% (from 3,959 to 3,699). The average Medicare beneficiary will have the option of 34 Medicare Advantage prescription drug (MA-PD) plans in 2025, just 2 fewer than the 36 options available in 2024. Since 2018, the number of plans available to the average beneficiary has doubled.

  • Reading the Stars: Nursing Home Quality Star Ratings, Nationally and by State

    Issue Brief

    This issue brief presents national and state-level analysis of nursing homes based on the Five-Star Quality Rating System, recently updated by the Centers for Medicare and Medicaid Services (CMS) to help consumers compare nursing homes when selecting one for themselves or their family members. The issue brief finds that more than one-third (36%) of the nation’s 15,500 nursing homes certified by Medicare or Medicaid received relatively low ratings of 1 or 2 stars (out of…

  • Medicare’s Income-Related Premiums Will Rise for Some Higher-Income Beneficiaries Beginning in 2018 

    News Release

    Some higher-income Medicare beneficiaries will have to pay more in Part B and Part D premiums starting in 2018, due to a provision in the Medicare Access and CHIP Reauthorization Act of 2015, a recently passed law to change how Medicare pays physicians. A Kaiser Family Foundation analysis finds that, as a result of the provision, Part B premiums are expected to rise from $238 per month to $310 per month for Medicare beneficiaries with…

  • 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…

  • Pieces of the Puzzle

    Report

    A new report describes the Report to Congress by the Department of Health and Human Services on consumer protection and quality assurance requirements for Medicaid managed care and discusses the differences between the original Federal rule and the revised one. Report Executive Summary  

  • 2001 Retiree Health and Prescription Drug Coverage Survey-6020

    Report

    2001 Retiree Health and Prescription Drug Coverage Survey This survey, released by the Kaiser Family Foundation, The Commonwealth Fund, and HRET, profiles retiree health coverage for Medicare-age (65+) retirees, including the amount retirees pay for coverage compared to active workers, cost-sharing for prescription drugs, and eligibility requirements for retiree benefits. The survey is based on the annual KFF/HRET Employer Health Benefits Survey News Release: New Survey Shows Retiree Health Benefits Continue to Decline Chart Pack

  • Medicare Beneficiaries: A Population At Risk – Findings from the Kaiser/Commonwealth 1997 Survey of Medicare Beneficiaries

    Other Post

    Medicare Beneficiaries: A Population at RiskFindings from the Kaiser/Commonwealth Fund 1997 Survey of Medicare Beneficiaries Tables for Medicare Beneficiaries: A Population at RiskPart 1 Cathy Schoen, Patricia Neuman, Michelle Kitchman, Karen Davis, and Diane Rowland List of Tables Table 1 Medicare Beneficiary Demographics, by Poverty Status Table 2 Medicare Beneficiary Demographics, by Age Group Table 3 Medicare Beneficiary Demographics, by Supplemental Insurance Type Table 4 Medicare Beneficiary Demographics, by Gender Table 1Medicare Beneficiary Demographics, by…