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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  • Prescription Drug Coverage for Medicare Beneficiaries: A Side-by-Side Comparison of Selected Proposals

    Report

    This updated document, prepared by Health Policy Alternatives, Inc., provides a side-by-side comparison of the House and Senate Medicare proposals, as passed on June 27, 2003. The side-by-side describes key provisions of H.R. 1, The Medicare Prescription Drug and Modernization Act of 2003, and S. 1, The Prescription Drug and Medicare Improvement Act of 2003. This updated document, which includes CBO's recent estimates of the costs of each bill and additional detail on payments to…

  • The Role of PBMs in Managing Drug Costs: Implications for a Medicare Drug Benefit

    Other Post

    Extending a drug benefit to Medicare beneficiaries has been a highly publicized issue in recent months. To address the question of how to finance and administer such a benefit while controlling its cost, some have proposed using pharmacy benefit managers (PBMs)--companies that administer pharmaceutical benefits for health plans, HMOs, and employers while managing drug utilization and obtaining discounts from both retail pharmacies and manufacturers. Most recently, the Clinton Administration introduced a proposal for a Medicare…

  • Retiree Health Coverage: Recent Trends and Employer Perspectives on Future Benefits

    Report

    The report, based on an analysis of Hewitt Associates' client database, presents new trend data on the prevalence of retiree health coverage sponsored by large employers and finds a continued erosion of retiree health benefits. The report also includes findings from a new survey assessing how large employers might change their retiree health programs in the future, and on their reaction to the Administration's proposal to add a prescription drug benefit to Medicare. The Hewitt…

  • Access To Health Care:

    Report

    Promises and Prospects For Low-Income Americans This book explores critical issues affecting access to health care for low-income Americans by assessing the importance of expansions of health coverage for the poor, the emerging challenges providers who serve low-income and uninsured populations face in a rapidly evolving health care delivery system, and the effects of these changes on particularly vulnerable populations. Articles include: IntroductionMarsha Lillie-Blanton, Rose Marie Martinez, Barbara Lyons, Diane Rowland A Review Of The…

  • Health News Index – May/June 2002

    Poll Finding

    Health News Index May/June, 2002 The Health News Index measures public attention to and knowledge about leading health stories covered in the news in April and May, including discussions in Congress about a Medicare prescription drug benefit and warnings by medical researchers about possible harmful side effects of newer prescription drugs compared to older, similarly effective drugs. The Health News Index is designed to help news media and people in the health field gain a…

  • Medicaid and HIV/AIDS Policy: A Basic Primer

    Report

    The Medicaid Primer presents in depth information on Medicaid, the federal/state program that provides health coverage for low-income families and people with disabilities and is the largest source of public financing for HIV/AIDS care in the U.S. The Medicaid Primer is designed to help policymakers and advocates navigate through the complexities of Medicaid with regard to the program's role for people with HIV/AIDS. REPORT Download

  • Solvency or Affordability?  Ways to Measure Medicare’s Financial Health

    Report

    Solvency or Affordability? Ways to Measure Medicare's Financial Health This report examines different ways of measuring Medicare s financial health and considers their implications for the future of the program and the people it serves. Using an alternative measure of Medicare's long-term affordability that focuses on workers' capacity to absorb additional costs over time, the analysis concludes that the nation could afford to pay more for Medicare in the future without imposing an undue burden…

  • Medicare State Profiles: State and Regional Data on Medicare and the Population it Serves

    Report

    Although Medicare is a national program, there are substantial variations across states and regions in terms of beneficiary characteristics, health needs, and utilization of Medicare-covered services. Likewise, there are also considerable differences in Medicare spending and the emergence of Medicare managed care. In a single resource document, , presents state-by-state demographic data on the Medicare population, along with information on health service utilization, spending, and Medicare HMO penetration. It also provides regional data on the…

  • Federal Budget Chartbook 2001

    Report

    A new chart book examines Fiscal Year 2002 budget proposals by President Bush and Congress, focusing on their impact on health programs. It provides both an examination of how health care programs fit into the overall U.S. budget and a review of past budget trends and future projections for government health care programs. Chartbook

  • Pulling it Together: Last Week’s Health Reform “Shocker”

    Perspective

    Last week we learned that health reform could cost the federal government at least a trillion dollars over ten years, and that it will be really difficult to forge bipartisan agreement on legislation and keep major interest groups on board. This obviously brought more angst to the deliberations, several Republicans seized the moment to criticize the Democrats' plans, and the press was all over it, with many commentators declaring health reform in dire straits. But…