Medicare

NEW AND NOTEWORTHY

Examining the Potential Impact of Medicare’s New WISeR Model

A federal initiative to establish new prior authorization requirements in traditional Medicare, called the Wasteful and Inappropriate Service Reduction (WISeR) model, is likely to have only modest impact in its first year.

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.

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  • To Switch or Be Switched: Examining Changes in Drug Plan Enrollment among Medicare Part D Low-Income Subsidy Enrollees

    Report

    During the Medicare Part D annual enrollment period, people on Medicare can review and compare stand-alone prescription drug plans (PDPs) and Medicare Advantage plans and switch plans if they choose. Low-income beneficiaries who receive premium and cost-sharing assistance through the Part D Low-Income Subsidy (LIS) program have a subset of premium-free PDPs (benchmark plans) available to them, but can also choose to enroll in a non-benchmark plan and pay a premium. This analysis examines plan…

  • Medicare And Medicaid At 50

    Poll Finding

    Medicare and Medicaid were signed into law by President Lyndon Johnson on July 30, 1965 in a bipartisan effort to provide health insurance coverage for low-income, disabled, and elderly Americans. In their 50 year history, each of these programs has come to play a key role in providing health coverage to millions of Americans today and make up a significant component of federal and state budgets. As major programs both in size and scope, their…

  • With Medicare and Medicaid Getting High Marks from the Public and Beneficiaries, Majorities Favor Status Quo over Major Structural Changes Such As Premium Supports or Block Grants

    News Release

    Among Medicare Changes, Strongest and Broadest Support Is for Negotiating Drug Prices People With Medicare, Medicaid and Employer Plans Give Their Coverage Similar Ratings, But Some Report Affordability and Physician Access Problems Fifty years after President Lyndon Johnson signed the law creating the Medicare and Medicaid programs, a new Kaiser Family Foundation poll finds a majority of the public and the vast majority of program beneficiaries view the two programs positively. Likely as a result,…

  • Data Note: Medicare Advantage Enrollment, by Firm, 2015

    Issue Brief

    A number of potential mergers and acquisitions between large firms that offer health insurance have been reported in the press. These mergers could affect consumers in the individual market, enrollees in the new federal and state Marketplaces, employees with employer-sponsored insurance, as well as people covered by public programs such as Medicare. This Data Note examines the Medicare Advantage market share of large firms that have reportedly engaged in merger and acquisition discussions: Aetna, Anthem,…

  • Amid Merger Talk, a Look at Health Insurers’ Medicare Business

    News Release

    With recent news about possible health insurance company mergers, Drew Altman looks beyond the impact on Wall Street to how mergers could affect Medicare beneficiaries in his latest column for The Wall Street Journal's Think Tank. All previous columns by Drew Altman are available.

  • Amid Merger Talk, a Look at Health Insurers’ Medicare Business

    From Drew Altman

    With recent news about possible health insurance company mergers, Drew Altman looks beyond the impact on Wall Street to how mergers could affect Medicare beneficiaries in this column for The Wall Street Journal's Think Tank.

  • Medicare Advantage Enrollment Continues to Climb, but Financial Protections for Enrollees Are Eroding 

    News Release

    Enrollment in Medicare Advantage continues to climb steadily as spending reductions enacted in the Affordable Care Act reduce historical overpayments to the private plans, according to a new analysis by the Kaiser Family Foundation. But limits on out-of-pocket spending for Medicare-covered services are rising, providing less protection for enrollees with relatively high health care expenses. Medicare Advantage enrollment grew in virtually all states and reached 16.8 million beneficiaries as of March 2015, an increase of…

  • Medicare Advantage 2015 Spotlight: Enrollment Market Update

    Issue Brief

    This Data Spotlight reviews national and state-level enrollment trends as of March 2015 and examines variation in enrollment by plan type and firm. It analyzes the most recent data on premiums, out-of-pocket limits, Part D cost-sharing for drugs, and plans’ quality ratings for Medicare Advantage enrollees.

  • A Gender Gap in Economic Security for Seniors

    News Release

    Following up on an earlier column for The Wall Street Journal's Think Tank on seniors and poverty, Drew Altman looks at why older women will be more at risk of economic insecurity than men in the future. All previous columns by Drew Altman are available.

  • A Gender Gap in Economic Security for Seniors

    From Drew Altman

    Following up on an earlier column for The Wall Street Journal's Think Tank on seniors and poverty, Drew Altman looks at why older women will be more at risk of economic insecurity than men in the future.