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.

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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  • Modifying Medicare’s Benefit Design: What’s the Impact on Beneficiaries and Spending?

    Report

    This report examines an approach to reforming Medicare that has been a focus of Congressional hearings and featured in several broader debt reduction and entitlement reform proposals, and was included in the June 2016 House Republican health plan. The analysis models four different options for modifying Medicare's benefit design, all of which include a single deductible, modified cost-sharing requirements, a new cost-sharing limit, and a prohibition on first-dollar Medigap coverage. The analysis models the expected…

  • Survey Finds Many Primary Care Physicians Have Negative Views of the Use of Quality Metrics and Penalties for Unnecessary Hospital Readmissions 

    News Release

    Primary Care Providers View Health IT as Improving Quality, But Tilt Negatively on ACOs Half of the nation's primary care physicians view the increased use of quality-of-care metrics and financial penalties for unnecessary hospitalizations as potentially troubling for patient care, according to a new survey from The Commonwealth Fund and the Kaiser Family Foundation. Fifty percent of primary care physicians say the increased use of quality metrics to assess provider performance is having a negative…

  • Adding an Out-of-Pocket Spending Maximum to Medicare: Implementation Issues and Challenges

    Issue Brief

    In an effort to simplify Medicare’s cost-sharing requirements, provide beneficiaries with catastrophic protection, and achieve program savings, some have proposed to restructure Medicare’s benefit design. Several recent proposals would create a unified deductible for Medicare Parts A and B, simplify cost-sharing requirements above the deductible, and add an annual limit on beneficiary out-of-pocket spending—a benefit feature typical of larger employer plans, but lacking in traditional Medicare. This issue brief describes the options for adding an…

  • Medicare Part D: A First Look at Plan Offerings in 2014

    Issue Brief

    The 2014 Part D Data Spotlight analyzes information about the Medicare Part D stand-alone prescription drug plan (PDP) options available to beneficiaries in 2014. The analysis shows that Medicare beneficiaries on average will have a choice of 35 stand-alone prescription drug plans in 2014, and somewhat more “benchmark” plans available to Low-Income Subsidy (LIS) beneficiaries nationwide. The weighted average premium will increase by 5 percent between 2013 and 2014 if enrollees remain in the same…

  • Drew Altman: 3 Takeaways From the Medicare Trustees Report

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman dives into this week’s release of the Social Security and Medicare Trustees Report to discuss the good news that may have been missed. All previous columns by Drew Altman are available online.

  • Visualizing Health Policy: The Role of Medicare Advantage

    News Release

    This Visualizing Health Policy infographic provides a snapshot of the role of Medicare Advantage plans, an alternative to traditional Medicare, including information about the proportion of Medicare beneficiaries who are enrolled in Medicare Advantage plans, geographic differences in Medicare Advantage penetration, the trend of increasing enrollment in Medicare Advantage plans, and the concentration of enrollment within a small number of firms and affiliates. It also shows the extent that Medicare has been paying more for…

  • New Interactive Takes a Look at Income and Assets Among Medicare Beneficiaries, Now and in the Future

    News Release

    A small share of the 52.4 million elderly individuals and people with disabilities on Medicare have relatively high incomes, but most are of modest means -- with half living on incomes of less than $23,500 last year. Although the majority of beneficiaries have some savings, the value of their assets varies dramatically, and is much lower for black and Hispanic than white beneficiaries, for widows than for widowers, and for younger Medicare beneficiaries with disabilities…

  • Views of the New Medicare Drug Law – Chartpack on People with Disabilities

    Report

    This comprehensive survey of people on Medicare, conducted in June and July 2004, assesses their attitudes toward the new Medicare drug law. This chartpack, issued in September 2004, presents additional analysis on the survey data, focusing on the views of people under age 65 with physical and/or mental disabilities. Supplemental Chartpack (.pdf)

  • Examining Medicare Part D Policies for Extended Supplies of Medication

    Issue Brief

    Medicare Part D plan sponsors, which provide drug coverage to 45 million older adults and people with disabilities, have the option to relax their ‘refill too soon’ restrictions in response to the COVID-19 pandemic, as part of efforts to ensure adequate access to medications in disasters or emergencies. This analysis examines the share of Part D enrollees who currently have access to extended supplies of generic, brand-name, and specialty-tier drugs covered by their plan in…