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.

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. 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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  • Snapshot of Where Hillary Clinton and Donald Trump Stand on Seven Health Care Issues

    Issue Brief

    Where do the 2016 Presidential candidates, Hillary Clinton and Donald Trump, stand on key health care issues? This snapshot outlines the candidates' positions and policy statements on issues such as health insurance, the ACA, Medicaid, Medicare, the opioid epidemic, prescription drug costs, women's reproductive health, and Zika.

  • Survey Finds Many Primary Care Physicians Have Negative Views of the Use of Quality Metrics and Penalties for Unnecessary Hospital Readmissions 

    News Release

    Primary Care Providers View Health IT as Improving Quality, But Tilt Negatively on ACOs Half of the nation's primary care physicians view the increased use of quality-of-care metrics and financial penalties for unnecessary hospitalizations as potentially troubling for patient care, according to a new survey from The Commonwealth Fund and the Kaiser Family Foundation. Fifty percent of primary care physicians say the increased use of quality metrics to assess provider performance is having a negative…

  • Dual Eligible Demonstrations: The Beneficiary Perspective

    Issue Brief

    This issue brief provides insights about initial implementation of the financial alignment demonstrations from the perspective of dual eligible beneficiaries in Massachusetts, Ohio, and Virginia, based on 12 individual interviews conducted in early 2015. Profiles of six beneficiaries are presented to illustrate representative program experiences, along with key findings from across all of the interviews.

  • “What is CMMI?” and 11 other FAQs about the CMS Innovation Center

    Fact Sheet

    The Center for Medicare and Medicaid Innovation (CMMI), also known as the "Innovation Center," was authorized under the Affordable Care Act with the goals of designing, implementing, and testing new payment and delivery system reform models to address concerns about rising costs, quality of care, and inefficient spending. These FAQs provide an overview of the Innovation Center, as well as details on model performance, beneficiary involvement, and more.

  • Adding an Out-of-Pocket Spending Maximum to Medicare: Implementation Issues and Challenges

    Issue Brief

    In an effort to simplify Medicare’s cost-sharing requirements, provide beneficiaries with catastrophic protection, and achieve program savings, some have proposed to restructure Medicare’s benefit design. Several recent proposals would create a unified deductible for Medicare Parts A and B, simplify cost-sharing requirements above the deductible, and add an annual limit on beneficiary out-of-pocket spending—a benefit feature typical of larger employer plans, but lacking in traditional Medicare. This issue brief describes the options for adding an…

  • Old and Poor: America’s Forgotten

    Video

    While the Census Bureau’s official poverty measure shows 9 percent of seniors nationally live in poverty, the share climbs to about one in seven seniors (15 percent) under the Bureau’s alternative Supplemental Poverty Measure, which takes into account out-of-pocket health expenses and geographic differences in the cost of living. Produced by the Kaiser Family Foundation, Old and Poor: America's Forgotten provides a portrait of seniors who are living in poverty, in both urban and rural…

  • Total Medicare Advantage Enrollment, 1992-2014

    Feature

    Total Medicare Advantage Enrollment, 1992-2014 Download Source MPR/Kaiser Family Foundation analysis of CMS Medicare Advantage enrollment files, 2008-2014, and MPR, “Tracking Medicare Health and Prescription Drug Plans Monthly Report,” 2001-2007.  Report of the Medicare Board of Trustees, 2002.

  • Medicare Part D: A First Look at Plan Offerings in 2014

    Issue Brief

    The 2014 Part D Data Spotlight analyzes information about the Medicare Part D stand-alone prescription drug plan (PDP) options available to beneficiaries in 2014. The analysis shows that Medicare beneficiaries on average will have a choice of 35 stand-alone prescription drug plans in 2014, and somewhat more “benchmark” plans available to Low-Income Subsidy (LIS) beneficiaries nationwide. The weighted average premium will increase by 5 percent between 2013 and 2014 if enrollees remain in the same…

  • Drew Altman: 3 Takeaways From the Medicare Trustees Report

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman dives into this week’s release of the Social Security and Medicare Trustees Report to discuss the good news that may have been missed. All previous columns by Drew Altman are available online.