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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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  • The New Medicare Prescription Drug Law:  Issues for Dual Eligibles with Disabilities and Serious Conditions

    Issue Brief

    The New Medicare Prescription Drug Law: Issues for Dual Eligibles with Disabilities and Serious Conditions The new issue paper discusses the challenges the new Medicare drug program faces in meeting the needs of dual eligible individuals with disabilities, who tend to have extensive, complex and varying needs. The brief examines four key questions about how the new benefit will serve dual eligibles with disabilities and profiles some individuals from this population for whom prescription drugs…

  • Issues for Medicare Beneficiaries in Long-Term Care Facilities: An Analysis of the MMA and Proposed Regulations

    Issue Brief

    This paper, by Vicki Gottlich, J.D., of the Center for Medicare Advocacy, looks at issues related to the new Medicare prescription drug benefit for people with Medicare who live in nursing homes or other long-term-care settings. It is one in a series commissioned by the Kaiser Family Foundation that analyzes issues surrounding the implementation of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA) and the proposed regulations. Issue Brief (.pdf)

  • Health Care Agenda for the New Congress – Chartpack

    Poll Finding

    This chartpack provides key findings from the 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…

  • Medicare Advantage: Take Another Look

    Perspective

    This Policy Insight explores possible explanations for the continued rise in Medicare Advantage enrollment between 2010 and 2013 in spite of a projected decrease following payment changes in the Affordable Care Act (ACA).

  • A Study of Medicare Advantage Plan Networks in 20 Counties Finds That Plans Include About Half of All Hospitals in Their Area 

    News Release

    A Kaiser Family Foundation analysis of private Medicare plan networks finds that Medicare Advantage plans include about  half of area hospitals in their network, on average, while one in five plans have no  Academic Medical Center in-network.  Among plans in an area with a National Cancer Institute-designated cancer center, more than two in five did not include the cancer center in their network. The new study of the hospital networks of Medicare Advantage plans, which…

  • Independent Payment Advisory Board (IPAB) Process: A Timeline

    Feature

    IPAB Timeline Download Source Kaiser Family Foundation, “The Independent Payment Advisory Board: A New Approach to Controlling Medicare Spending,” 2011, https://www.kff.org/health-reform/issue-brief/the-independent-payment-advisory-board-a-new/.

  • 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.