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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  • The Olmstead Decision: Implications for Medicaid

    Issue Brief

    In June, 1999, the Supreme Court rule in Olmstead v L.C. that states were required to provide services to persons with disabilities in community settings rather than institutions, if certain conditions were met. This Policy Brief provides an overview of the Olmstead case, including the facts, the court ruling, and the disposition of the case. In addition, the brief describes the issues surrounding implementation and the implications this ruling could have for state Medicaid programs.…

  • Medicare and Medicaid for the Elderly and Disabled Poor

    Fact Sheet

    This fact sheet provides an overview of the role of Medicare and Medicaid in serving these beneficiaries, describes the health status of dual Medicare/Medicaid beneficiaries, and discusses issues of managed care and access to care.This fact sheet is a summary of a longer Background Paper (#2132), which is also available. Fact Sheet

  • Chart Pack: Views on the Medicare Prescription Drug Benefit

    Poll Finding

    This chartpack highlights key results and trends from the Kaiser Family Foundation's August 2005 tracking poll looking at seniors' views and knowledge about the new Medicare prescription drug benefit. Survey Chartpack (.pdf)

  • Medicare Part D: Issues for Dual Eligibles on the Eve of Implementation

    Issue Brief

    Medicare Part D: Issues for Dual Eligibles on the Eve of Implementation This issue brief describes how dual eligibles are treated under the Medicare drug benefit and the issues raised by their transition from Medicaid to Medicare drug coverage. The brief also explores key differences in the Medicare drug benefit compared to Medicaid drug coverage (formularies, copayments, and appeals policies) which could make the shift especially challenging for dual eligibles. Issue Brief (.pdf)

  • Medicare Part D 2008 Data Spotlight: Utilization Management

    Issue Brief

    This Medicare Part D data spotlight examines three common techniques used by Medicare stand-alone prescription drug plans in 2008 to manage enrollees’ use of formulary drugs, such as quantity limits, prior authorization, and step therapy rules. This is one in a series analyzing key aspects of the 2008 Medicare Part D prescription drug plan choices. It analyzes data from the 47 stand-alone prescription drug plans available nationwide using a sample of 169 commonly-used and high-cost…

  • A Primer on Dually Eligible Beneficiaries

    Event Date:
    Event

    The nine million dually eligible beneficiaries are generally poorer and sicker than other Medicare beneficiaries, tend to use more health care services, and thus account for a disproportionate share of Medicare and Medicaid spending. Because they often have complex medical and long-term care needs, and must navigate both Medicaid and Medicare benefits and financing, they present a special challenge for those seeking a more efficient and coordinated care delivery system. The panel will address such…

  • Medigap Reforms: Potential Effects of Benefit Restrictions on Medicare Spending and Beneficiary Costs

    Report

    As part of several debt-reduction and Medicare-reform proposals, some policymakers propose to prohibit Medicare supplemental insurance policies (known as Medigap) from covering all of enrollees' out-of-pocket Medicare costs, which some believe leads to higher use of services and higher Medicare spending. Such changes would expose Medigap enrollees – currently about one in six Medicare beneficiaries – to a larger share of Medicare's cost-sharing requirements. This analysis commissioned by the Kaiser Family Foundation examines three potential…

  • Medigap Reform: Setting the Context for Understanding Recent Proposals

    Issue Brief

    This brief presents the most current data available on the Medicare supplemental insurance (Medigap) market, including enrollment and premiums by state and plan type, analyzes how many beneficiaries have first dollar coverage (particularly Plans C and F), and describes recent Medigap proposals that have emerged as part of efforts to reduce Medicare spending and the national debt.

  • Poll Finds Bipartisan Public Support For Creating State Insurance Exchanges Despite Continuing Party Divisions Over the ACA

    News Release

    More Americans Back Than Oppose State Medicaid Expansions But, Like Many Governors, Public Splits Along Party Lines On The Federal Deficit, Public Wants Action But Still Resists Most Cuts and Sacrifices, Especially to Medicare A majority of Americans put the creation of state-based health insurance exchanges at the top of the priority list for health policy in their state this year, according to a survey released today by the Kaiser Family Foundation, the Robert Wood…