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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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  • What is Medicare’s Role in End-of-Life Care?

    News Release

    Medicare plays an integral role in end-of-life care, an issue that is emotionally-charged and easily politicized.  About three-quarters of the 2.5 million Americans who die each year are ages 65 and older, and covered by Medicare at the time of their death, yet policy issues related to Medicare and end-of-life care are often poorly understood. As policymakers consider whether and how Medicare should pay physicians and other health care professionals for talking to Medicare beneficiaries…

  • What’s In and What’s Out? Medicare Advantage Market Entries and Exits for 2016

    Issue Brief

    This Issue Brief examines the availability of Medicare Advantage plans nationwide and by state in 2016, and tracks changes in plan availability since 2012. It documents the number and share of Medicare Advantage enrollees affected by plan withdrawals each year, the characteristics of plans that will be entering or exiting the market in 2016, and the potential implications of these changes for Medicare Advantage enrollees.

  • Brief Explains Why Medicare Part B Premiums Will Increase by 16 percent, not 52 percent, in 2016 for 3 in 10 Beneficiaries Due to the Recent Budget Deal

    News Release

    As a result of the recently enacted budget deal in Congress, the 2016 Medicare Part B monthly premium will be $121.80, increasing by 16 percent over the 2015 amount—far lower than the increase initially projected by the Medicare actuaries, a new brief from the Kaiser Family Foundation explains. The Part B premium increase will affect 3 in 10 Medicare beneficiaries. The remaining 7 in 10 beneficiaries will pay the same $104.90 monthly premium in 2016…

  • Modifying Traditional Medicare’s Benefit Design Could Reduce Federal Spending But With Cost Tradeoffs Between Beneficiaries and The Federal Government

    News Release

    Revamping traditional Medicare’s benefit design and restricting “first-dollar” supplemental coverage could reduce federal spending, simplify cost sharing, protect against high medical costs, decrease out-of-pocket spending for many beneficiaries, and provide more help to those with low incomes -- but would be unlikely to achieve all of these goals simultaneously.

  • Medicare-for-All’s Popularity May Have Peaked

    From Drew Altman

    In this Axios column, Drew Altman looks at the polling trend on support for Medicare-for-all suggesting it may have crested as criticism has mounted. He considers what it means for the Democratic primary and continued debate for Medicare-for-all and other expansion proposals.

  • Variations in State Medicaid Buy-in Practices for Low-Income Medicare Beneficiaries: A 1999 Update

    Report

    This report updates a 1997 Foundation report to assess how states are implementing financial protections for the 16 million Medicare beneficiaries who are low-income. These protections, generally referred to as "buy-in programs," help low-income Medicare beneficiaries meet Medicare's cost-sharing requirements by using state Medicaid programs to pay either all or some portion of premiums, deductibles, and coinsurance amounts. Using information collected through a survey of state Medicaid directors and consumer advocates, the update seeks to…

  • Medicare Drug Discount Cards: A Work In Progress

    Report

    This report examines the early experience with the Medicare-Approved Drug Discount Card Program, prices offered by card sponsors, and potential savings for enrollees. The report presents information about approved discount card programs, including sponsors, enrollment fees, and drugs covered, as well as beneficiary education and outreach efforts by the Centers for Medicare & Medicaid Services. The pricing analysis shows that discount cards can deliver savings off of full retail drug prices, but also that savings…

  • Health Care Agenda for the New Congress – Toplines

    Poll Finding

    This document includes the complete toplines from a survey of the public's attitudes regarding the health care agenda for Bush's second term and the new Congress in 2005. It assesses the relative priority placed on health-care concerns by the American public and also provides insight into public opinion on key issues likely to face the new Congress, such as implementing the Medicare drug law, controlling health care costs, reducing the nation’s uninsured population and reforming…

  • The State of Retiree Health Benefits: Historical Trends and Future Uncertainties

    Event

    Tricia Neuman, Vice President and Director of the Medicare Policy Project for the Kaiser Family Foundation, testified on Monday, May 17, at a U.S. Senate Committee on Aging hearing on issues relating to retiree health coverage, "Access to Adequate Health Insurance: How Does the Equal Employment Opportunity Commission's Recent Rule Affect Retiree Health Benefits?" Testimony (.pdf) Webcast of Hearing

  • New Trump Administration Proposals Would Further Limit Gender Affirming Care for Young People by Restricting Providers and Reducing Coverage

    Issue Brief

    This brief examines two proposed federal rules that would further restrict youth access to gender affirming care. One rule would change the hospital Conditions of Participation (CoPs) which would prohibit most Medicare and Medicaid enrolled hospitals from providing certain types of gender affirming medical care for young people and the other would prohibit federal Medicaid or CHIP funds from covering this care. The rules have a 60-day comment period, do no take immediate effect, and…