Medicare

NEW AND NOTEWORTHY

What to Know About Medicare Coverage of Telehealth

Congress has repeatedly extended pandemic-era flexibilities around Medicare coverage of telehealth, but most such flexibilities remain temporary. This brief answers key questions about the current scope of Medicare telehealth coverage, including both temporary and permanent changes adopted through legislation and regulation, and future policy considerations.

Changes to the Medicare Advantage Program Enhance Some Consumer Protections But Roll Back Others

CMS recently finalized policies as part of the 2027 Medicare Advantage final rule that both enhance consumer protections and roll back changes to the Medicare Advantage program that were intended to protect consumers. These changes have gotten less attention than payment issues and changes to the star ratings system, which also affect plan payments, but could have implications for Medicare beneficiaries.

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. u003cbru003eu003cbru003eExplore 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.u003cbru003eu003cbru003eu003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022 data-type=u0022linku0022 data-id=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003eRelated:u003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003e FAQs on Medicare Financing and Trust Fund Solvencyu003c/au003eu003c/au003e

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  • Seniors and Income Inequality: How Things Get Worse With Age

    From Drew Altman

    In this column for The Wall Street Journal’s Think Tank, Drew Altman discusses why seniors need to be included in the national discussion on income inequality, especially as proposals to change Medicare and Social Security are considered.

  • Medicare’s Income-Related Premiums Will Rise for Some Higher-Income Beneficiaries Beginning in 2018 

    News Release

    Some higher-income Medicare beneficiaries will have to pay more in Part B and Part D premiums starting in 2018, due to a provision in the Medicare Access and CHIP Reauthorization Act of 2015, a recently passed law to change how Medicare pays physicians. A Kaiser Family Foundation analysis finds that, as a result of the provision, Part B premiums are expected to rise from $238 per month to $310 per month for Medicare beneficiaries with…

  • Medicare’s Income-Related Premiums: A Data Note

    Issue Brief

    This data note presents new information to help set a context for understanding the implications of recent changes to Medicare's income-related premiums incorporated in the Medicare Access and CHIP Reauthorization Act of 2015 (MACRA), a new law to repeal and replace Medicare's Sustainable Growth Rate (SGR) formula for physician payments. It describes current requirements with respect to the income-related premiums under Medicare Part B and Part D, including the number and share of Medicare beneficiaries…

  • More Than 1 in 3 Nursing Homes Received Relatively Low Overall Ratings on Nursing Home Compare

    News Release

    More than one third of the nation’s 15,500 nursing homes, accounting for 39 percent of all nursing home residents, received relatively low ratings of 1 or 2 stars under the federal government’s recently revamped Five-star Quality Rating System, according to a new analysis by the Kaiser Family Foundation. The rating system, overseen by the Centers for Medicare and Medicaid Services, assigns ratings of 1 to 5 stars to all Medicare- and Medicaid-certified nursing homes based…

  • Reading the Stars: Nursing Home Quality Star Ratings, Nationally and by State

    Issue Brief

    This issue brief presents national and state-level analysis of nursing homes based on the Five-Star Quality Rating System, recently updated by the Centers for Medicare and Medicaid Services (CMS) to help consumers compare nursing homes when selecting one for themselves or their family members. The issue brief finds that more than one-third (36%) of the nation’s 15,500 nursing homes certified by Medicare or Medicaid received relatively low ratings of 1 or 2 stars (out of…

  • Medicare: An Overview

    Feature

    This slideshow explains key elements of the Medicare program, which now provides health coverage to 55 million people — including 46 million people age 65 and older and another 9 million younger adults with permanent disabilities.

  • Demonstrations to Improve the Coordination of Medicare and Medicaid for Dually Eligible Beneficiaries: What Prior Experience Did Health Plans and States Have with Capitated Arrangements?

    Report

    This report examines the Center for Medicare and Medicaid Services (CMS) financial alignment demonstration for beneficiaries dually eligible for Medicare and Medicaid, with a focus on the extent to which participating states and health plans have prior experience with capitated managed care arrangements under Medicare or Medicaid, and specifically for this population. Under these capitated financial alignment demonstrations, health plans contract with the state and CMS (a three-way contract) to provide both Medicare and Medicaid…