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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.

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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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  • Pitching Private Medicare Plans: An Analysis of Medicare Advantage and Prescription Drug Plan Advertising

    Other Post

    This Kaiser Family Foundation report analyzes the content and frequency of television, print and radio advertisement for private Medicare plans that ran nationally or in one of three local media markets (Miami/Fort Lauderdale, Fla.; Phoenix, Ariz.; and Greensboro, N.C.) during the marketing and enrollment period for 2008 plan offerings. All ads were identified by VMS, a media monitoring service. The study finds that insurers last year placed three times more advertisements to promote Medicare Advantage…

  • Briefing – Medicare: A Primer

    Event Date:
    Event

    This briefing provided an overview of the Medicare program and its role in the health care system. Panelists discussed who is eligible for Medicare, what benefits are covered and how the program is administered. Medicare financing and the program's role in health reform was also explained. More information on Medicare from the Kaiser Family Foundation can be found in the related documents below. This March 11 briefing was cosponsored by the Kaiser Family Foundation and…

  • Prescription Drug Procurement and the Federal Budget

    Issue Brief

    This brief commissioned by the Foundation considers areas where Medicare faces limited opportunity for market-based competition and price negotiation to drive down drug spending. These areas include drug purchasing for low-income people enrolled in Part D plans who face minimal cost-sharing requirements, and purchasing certain unique drugs, such as biologicals, that have no therapeutic alternatives or competitors. Authored by Richard G. Frank of Harvard University, the brief discusses policy options that could lower Medicare spending…

  • Pulling it Together: When Premiums Go Up 39%

    Perspective

    Our group that works on health care cost issues just updated an analysis that sheds light on what’s really happening to people in the individual health insurance market, the issue Secretary Sebelius, a former Kansas insurance commissioner, and others have put in the spotlight by calling on Anthem and other insurance companies to account for their proposed high premium increases. The analysis shows that people buying health insurance on their own in the individual market…

  • Tracking Poll Finds Seniors Split on Medicare Drug Benefit

    Poll Finding

    Tracking Poll Finds Seniors Now Split on Medicare Drug Benefit This August tracking survey shows modest progress in seniors' knowledge about the Medicare drug benefit. Also, for the first time, the tracking poll shows seniors are as likely to say that they have a favorable impression of the drug benefit as an unfavorable one. The Kaiser Health Poll Report Survey was conducted and analyzed by researchers at the Kaiser Family Foundation. A nationally representative sample…

  • Toplines: July/August 2005 Health Poll Report Survey

    Poll Finding

    Health News Index July/August, 2005 These toplines provide the complete survey questions and responses to the July/August 2005 Kaiser Health Poll Report, a bimonthly report designed to provide key tracking information on public opinion about health care topics to journalists, policymakers and the general public. It includes a series of questions on seniors' views and knowledge about the Medicare prescription drug benefit. Topline/Survey

  • An Implementation Perspective on Part D, the Medicare Prescription Drug Program

    Report

    This focus group of 12 state Medicaid officials conducted in November 2005 explores the current status and likely results of the Part D dual eligible transition efforts as well as other Part D-related issues of particular importance to states. It includes discussion of the transition of dual eligibles from Medicaid to Medicare drug coverage, evaluating Part D plan options, states’ role in the low-income subsidy program, the fiscal implications of Part D to states, and…

  • Medicare Part D Data Spotlight: A First Look at Part D Plan Offerings in 2012

    Report

    This data spotlight examines the stand-alone Part D drug plan options available to Medicare beneficiaries in 2012. Medicare beneficiaries will, on average, be able to choose from 31 stand-alone Medicare Part D prescription drug plans to choose from, a new Kaiser analysis finds. Average premiums would increase by 4 percent from 2011 to 2012 if beneficiaries remain with their current plans during the open enrollment period, which begins October 15 and December 31. That represents…

  • Designing a Medicare Drug Discount Card: Implications of Policy Choices for Medicare Beneficiaries and Plan Sponsors

    Report

    This report analyzes key issues surrounding the implementation of a Medicare-endorsed prescription drug discount card program. Medicare prescription drug discount cards have been proposed as a short-term strategy for lowering prescription drug costs for Medicare beneficiaries. The report considers the implications for both discount card sponsors and beneficiaries of alternative program designs, including such features as the annual lock-in for consumers, exclusive formularies, providing comparative information to consumers about drug prices and discounts, administration of…

  • Financial Incentives in the Long-Term Care Context: A First Look at Relevant Information

    Report

    Financial Incentives in the Long-Term Care Context: A First Look at Relevant Information This report reviews Medicare's payment policies as they may affect medical care for residents in long-term care environments, including a look at the financial incentives that could play a role in hospital and skilled nursing facility admissions. The report was prepared by Henry Desmarais at Health Policy Alternatives for the Foundation and released at an Oct. 12, 2010, policy briefing. Report (.pdf)