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.

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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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  • Brief Examines Five Potential Ways to Improve Dental Coverage for People on Medicare

    News Release

    Medicare does not cover routine dental care, and two-thirds of the Medicare population have no dental coverage at all. With limited or no dental coverage, some incur high out-of-pocket costs, while others forgo need dental care because they can’t afford it. Policymakers in Washington and others are exploring ways to make dental care more affordable for the 60 million people on Medicare. A new KFF brief examines five potential ways to make oral health care…

  • 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.

  • Implications of “Medicare for All” and “Public Plan” Strategies: New Brief and Interactive Tool Summarize Legislative Proposals and Key Issues

    News Release

    The idea of expanding the role of government programs such as Medicare and Medicaid has received renewed attention on Capitol Hill and on the campaign trail this year as policymakers consider ways to expand health insurance coverage and moderate health care costs. Lawmakers have introduced eight such proposals in the current Congress. They range from bills that would create a new, all-encompassing national health insurance program (sometimes called “Medicare-for-All”) to less sweeping measures that would…

  • Why We Are Stuck with Prior Authorization Review

    From Drew Altman

    Prior authorization review frustrates patients and physicians, but we likely can’t just eliminate it. In his new column, President and CEO Dr. Drew Altman discusses why, and why the focus is now instead on “doing it smarter.” Altman writes: “A proposal to eliminate prior authorization altogether could be the single most tangible and popular health reform idea a candidate could make. But, in our fragmented health system, with no great way to control costs or…

  • Understanding the Trump Administration’s Negotiated Drug Prices for Medicare

    Quick Insights

    While Republicans in Congress have largely opposed the IRA and Medicare drug price negotiation, President Trump appears to be embracing it. With this latest announcement, the Trump administration can take credit for delivering lower drug prices in Medicare, while Democrats can take credit for creating the Medicare drug price negotiation program in the first place.

  • Key Findings: Kaiser Health Tracking Poll — November 2009

    Poll Finding

    This document contains the key findings from the November Health Tracking Poll. The survey was designed and analyzed by public opinion researchers at the Kaiser Family Foundation and was conducted November 5 through November 12, 2009, among a nationally representative random sample of 1,203 adults ages 18 and older. Telephone interviews conducted by landline (802) and cell phone (401, including 112 who had no landline telephone) were carried out in English and Spanish. The margin…

  • Restructuring Medicare’s Benefit Design: Implications for Beneficiaries and Spending

    Report

    Several deficit-reduction plans have proposed combining Medicare's separate deductibles for hospital and physician services, standardizing cost sharing across types of benefits, and establishing a new limit on annual out-of-pocket costs for beneficiaries. A new Kaiser Family Foundation study examines the potential implications of proposals to revamp Medicare’s cost-sharing requirements as a way of reducing federal spending. The analysis projects what would happen if Medicare's current benefit design were replaced with a unified deductible of $550;…

  • An Update on CMS’s Capitated Financial Alignment Demonstration Model For Medicare-Medicaid Enrollees

    Issue Brief

    Beginning in January, 2013, the Centers for Medicare and Medicaid Services (CMS) will implement a three year multi-state demonstration to test new service delivery and payment models for people dually eligible for Medicare and Medicaid. These demonstrations will enroll full dual eligibles in managed fee-for-service or capitated managed care plans that seek to integrate benefits and align financial incentives between the two programs. On January 25, 2012, CMS issued a memorandum providing additional guidance for…

  • Transforming Medicare into a Premium Support System: Implications for Beneficiary Premiums

    Report

    This study illustrates why geography would matter for Medicare beneficiaries under a premium support system that relies on a competitive bidding process envisioned under several key Medicare reform proposals. It examines potential changes in the premiums paid by Medicare beneficiaries under a payment approach that caps federal contributions per beneficiary based on the cost of the second lowest-bidding private plan or traditional Medicare, whichever is lower in their area. Under this approach, beneficiaries can choose…