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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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  • Nursing Home Staffing Standards

    Report

    This policy brief describes the current federal staffing requirements and how states separately regulate staffing levels in nursing homes. It also presents data showing actual staffing levels in over half of this country's nursing homes exceed the levels that states and the federal government require. Report PDF Download

  • 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…

  • Health News Index – July/August 2000

    Poll Finding

    Health News Index July/August, 2000 The July/August 2000 edition of the Kaiser Family Foundation/HarvardSchool of Public Health, Health News Index includes questions about major health stories covered in the news, including questions about the Supreme Court's recent decisions and House action on proposals for providing drug coverage to seniors. The Health News Index is designed to help the news media and people in the health field gain a better understanding of which health stories in…

  • Prescription Drug Trends: A Chartbook

    Report

    Prescription Drug Trends - A Chartbook, an analysis by the Kaiser Family Foundation and the Sonderegger Research Center, University of Wisconsin-Madison, provides information about trends in prescription drug coverage, spending, prices, use, and industry structure. Although overall coverage for prescription drugs has increased over the last decade, about a quarter of the nonelderly and a third of Medicare beneficiaries have no drug coverage. Spending for prescriptions is one of the fastest growing components of health…

  • 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…

  • A Study of Media Coverage of Health Policy 1997-2000

    Poll Finding

    The debate over President Clinton's national health care reform plan put health care policy at the forefront of the national agenda in 1993 and 1994. After the end of that debate, it remained to be seen whether or not health policy would hold the media's and the public s interest to the same degree. To help answer that and other questions, a comprehensive study of health policy media coverage from 1997 through 2000 - focusing…

  • An Analysis of Reforming Medicare Through a ‘Premium Support’ Program

    Report

    An Analysis of Reforming Medicare Through a 'Premium Support' Program This report examines one of the leading approaches to reforming the Medicare program, known as premium support. Under this model, the current Medicare program would be replaced by a system of competing public and private health plans, and the federal government would pay a set amount per beneficiary. The authors conclude that, while premium support could potentially improve Medicare's efficiency and improve quality, traditional Medicare…

  • Seniors and Prescription Drugs: An 8-State Survey

    Report

    A new study conducted by researchers at Tufts-New England Medical Center, the Henry J. Kaiser Family Foundation, and the Commonwealth Fund, reports results from a 2001 survey of 10,927 noninstitutionalized seniors in eight geographically diverse states: California, Colorado, Illinois, Michigan, New York, Ohio, Pennsylvania, and Texas. State-level data on drug coverage, medication use, out-of-pocket costs, and cost-related medication skipping among community-dwelling seniors are highlighted to examine how coverage and experiences differ by state and how…