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.

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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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  • Limiting Private Insurance Reimbursement to Medicare Rates Would Reduce Health Spending by About $350 Billion in 2021

    Issue Brief

    This analysis estimates the total annual reduction in health care spending by employers and privately insured individuals that would result from having private insurers reimburse hospitals and other health care providers at Medicare rates. In total, we estimate spending for the privately insured population would be an estimated $352 billion lower in 2021 if employers and other insurers reimbursed health care providers at Medicare rates.

  • The Growth of Private Plans in Medicare, 2006

    Issue Brief

    , details the different types of private plan options available to people on Medicare. These include Medicare Advantage plans (such as Medicare HMOs, PPOs and private fee-for-service plans) and new stand-alone prescription drug plans. • In 2006, all Medicare beneficiaries have access to at least one type of private Medicare Advantage plan, up from 77% in 2004. The increase in access stems largely from the creation of new Medicare regional PPOs and the expansion of…

  • An Examination of Medicare Private Fee-for-Service Plans

    Issue Brief

    This March 2007 issue brief, commissioned by the Kaiser Family Foundation, provides insight Medicare private fee-for-service plans, the most rapidly growing type of Medicare Advantage plan. As of February 2007, these plans enrolled 1.3 million beneficiaries, up from just 209,000 in December 2005. The paper examines the history of these plans, their key features, trends related to their availability and enrollment and their implications for Medicare beneficiaries. Jonathan Blum, Ruth Brown and Miryam Frieder of…

  • President Obama’s Campaign Position on Health Reform and Other Health Care Issues

    Issue Brief

    During the 2008 Presidential campaign now President Barack Obama announced a comprehensive health care reform proposal and laid out his positions on a number of other key health care issues. The two documents below summarize these campaign policies and positions. They were prepared by the Kaiser Family Foundation with the assistance of Health Policy Alternatives, Inc., and are based on information compiled from Obama's campaign Web site, speeches, campaign debates and news reports. They are…

  • Medicare Advantage 2011 Data Spotlights

    Report

    Now Available: 2012 Medicare Advantage Spotlight: Plan Availability and Premiums The Kaiser Family Foundation has issued a series of data spotlights and issue briefs examining the Medicare Advantage plan options available in 2011 and trends affecting the Medicare Advantage marketplace. These analyses were prepared by researchers at Mathematica Policy Research, Inc. and the Kaiser Family Foundation. Medicare Advantage Enrollment Market Update Firm Perspectives on the Medicare Advantage Market Plan Availability and Premiums

  • Medicare Beneficiaries and HMOs: A Case Study of the Portland Market

    Report

    This case study of the evolution of Medicare managed care in Portland, Oregon, is part of a series of four case studies being prepared for the Kaiser Family Foundation to learn more about the factors influencing, and consequences of, the growth of Medicare managed care. Portland was one of the first markets to implement a Medicare managed care program, with the Kaiser Foundation Health Plan beginning its Medicare HMO in 1978 and all four of…

  • Medicaid’s Role for the Disabled Population Under Age 65

    Fact Sheet

    Medicaid's Role for the Disabled Population Under Age 65 Defines the non-elderly disabled and summarizes Medicaid's role in their health care coverage. Includes a description of enrollment requirements, benefits, spending and managed care concerns for the population. Fact Sheet

  • Disability, Health Coverage, and Welfare Reform

    Report

    This report analyzes data from a survey of 42 low-income families with children with moderate or severe disabilities to better understand the impact of welfare reform on health coverage for these families. Report

  • 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…