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.

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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  • Faces of Dually Eligible Beneficiaries: Profiles of People with Medicare and Medicaid Coverage

    Issue Brief

    This brief examines the role of Medicare and Medicaid in the lives of dually eligible beneficiaries – low-income seniors and younger adults with disabilities who are eligible for both programs – through personal profiles. It includes a glossary of eligibility and service delivery system terms and state-level enrollment and expenditure data for dual eligibles.

  • Development of the Financial Alignment Demonstrations for Dual Eligible Beneficiaries: Perspectives from National and State Disability Stakeholders

    Issue Brief

    This issue brief provides an early snapshot into disability community perspectives on state design and implementation efforts related to the new financial alignment demonstrations for beneficiaries dually eligible for Medicare and Medicaid, with an emphasis on non-elderly beneficiaries and those who use long-term services and supports.

  • Does Education Narrow the Gap in Wealth Among Older Adults, by Race and Ethnicity?

    Issue Brief

    This analysis of per capita income and assets among older adults in 2019 shows that differences in median per capita income among White, Black, and Hispanic adults ages 65 and older are narrower when comparing people with similar levels of education, although among college graduates, the gap in income continues to be wide between Hispanic and White seniors. The gaps in savings and home equity remain wide, and are particularly striking among seniors with less…

  • Summary of Costs and Impact of the Prescription Drug Provisions in the Build Back Better Act

    News Release

    As the House-passed Build Back Better Act moves to the Senate, a new explainer from KFF summarizes the key prescription drug provisions within the broader budget reconciliation bill. These provisions would lower prescription drug costs paid by people with Medicare and private insurance and curb drug spending by the federal government and private payers. The Congressional Budget Office estimates federal budget savings from the drug pricing provisions would be $297 billion over 10 years. Although…

  • States Have Made Progress in Vaccinating Older Adults Against COVID-19 in Recent Weeks, But No State Has Vaccinated At Least Half of its Older Population

    News Release

    Twenty-two states and the District of Columbia have vaccinated at least one-third of their residents who are 65 and older against COVID-19, an updated KFF analysis finds, but no state has crossed the threshold of vaccinating 50 percent or more of its older population. The share of adults 65 and older who have received at least one dose of a vaccine ranges from 49 percent in North Carolina to 27 percent in Pennsylvania. (The relatively low…

  • Many Medicare Beneficiaries Face High Out-of-Pocket Costs for Dental and Hearing Care, Whether in Traditional Medicare or Medicare Advantage

    News Release

    Many Medicare beneficiaries face high annual out-of-pocket costs for dental and hearing care -- services that generally aren’t covered in traditional Medicare, but typically are covered by Medicare Advantage plans though the scope and value of these benefits vary, finds a new KFF analysis. The analysis shows that, among beneficiaries who used each type of service, average annual out-of-pocket spending was $914 for hearing care and $874 for dental care in 2018, but considerably less…

  • What’s the Latest on Medicare Drug Price Negotiations?

    Issue Brief

    In response to prescription drug spending growth and heightened attention to drug prices, some policymakers have proposed allowing the federal government to negotiate the price of prescription drugs for Medicare and private payers. This brief describes the current status of drug price negotiation proposals, looks back at the history of proposals to give the federal government the authority to negotiate drug prices in Medicare, describes the negotiation provisions in key legislation (H.R. 3), and discusses…

  • Expanding Medicare to Adults at Age 60 Years—Medicare-for-More?

    Perspective

    In this column for the JAMA Health Forum, Larry Levitt examines the implications of lowering Medicare’s age of eligibility, which is emerging as a potential pathway toward Medicare-for-all or a public option among single-payer advocates. He explores the implications for costs, industry, people and broader reform efforts.

  • Medicare and Medicaid at 50

    Video

    With Medicare and Medicaid turning 50 this year, this updated video provides a brief history of both programs, including: an examination of the health care, social and political landscape that gave rise to them, the significant ways each program has evolved over five decades, and the important roles they play in the U.S. health care system. The video includes archival footage, as well as commentary and perspective from policymakers, government officials and experts.