Medicare

New & Noteworthy

What to Know About Pharmacy Benefit Managers and Federal Efforts at Regulation

The top three pharmacy benefit managers (PBMs) manage 79% of prescription drug claims on behalf of 270 million people. We look at the role PBMs play in influencing drug costs and access to medicines, as well as efforts to regulate them.

State Profiles for Dual-Eligible Individuals

This data collection draws on Medicare and Medicaid administrative data to present national and state-level information on people who are covered by both Medicare and Medicaid, referred to as dual-eligible individuals (also known as dually-enrolled beneficiaries).

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.

Related: FAQs on Medicare Financing and Trust Fund Solvency

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  • What’s in Store for Medicare’s Part B Premiums and Deductible in 2016, and Why?

    Issue Brief

    As a result of the recently-enacted Bipartisan Budget Act of 2015, the Medicare Part B monthly premium will be $121.80 in 2016 according to the Centers for Medicare and Medicaid Services, an increase of 16 percent over the 2015 amount for 30 percent of beneficiaries —far lower than the 52 percent increase initially projected by the Medicare actuaries. This Issue Brief reviews how Medicare Part B premiums and deductibles are affected by the recent budget deal (including the premium surcharge that covers the costs) and explains the connection between the Social Security cost-of-living adjustment (COLA), Medicare premiums, and the “hold harmless” provision that will keep premiums flat for 70 percent of beneficiaries in 2016.

  • Primary Care Physicians Accepting Medicare: A Snapshot

    Issue Brief

    This Data Note presents findings on reported acceptance of Medicare patients among non-pediatric primary care physicians, based on data from the Kaiser Family Foundation/Commonwealth Fund 2015 National Survey of Primary Care Providers. In addition to comparing physicians’ acceptance of Medicare to private insurance and Medicaid, this Data Note also explores the characteristics of non-pediatric primary care physicians who accept new Medicare patients and who have greater shares of Medicare patients in their caseloads.

  • Medicare Advantage and Traditional Medicare: Is the Balance Tipping?

    Issue Brief

    In this brief, we look beneath national trends to examine Medicare Advantage penetration rates and growth rates in counties across the country to assess the extent to which Medicare Advantage plans are poised to cover more beneficiaries than traditional Medicare across the country.

  • Medicare Open Enrollment Preview

    Event Date:
    Event

    With Medicare Advantage (Part C) and prescription drug (Part D) open enrollment beginning October 15th, this briefing took a close look at what to expect, including trends in premiums and cost sharing, plan availability and benefit design.

  • Medicare Part D: A First Look at Plan Offerings in 2016

    Issue Brief

    During the Medicare open enrollment period, beneficiaries have the opportunity to enroll in a plan that provides Part D prescription drug coverage, either a stand-alone prescription drug plan (PDP) to supplement traditional Medicare, or a Medicare Advantage drug plan. This issue brief provides an overview of the 2016 PDP marketplace, focusing on key changes from 2015, based on analysis of data from the Centers for Medicare & Medicaid Services. It presents analysis of PDP availability, premiums, benefit design, and low-income subsidy plans.

  • 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.