Medicare

NEW AND NOTEWORTHY

What to Know About Medicare Coverage of Telehealth

Congress has repeatedly extended pandemic-era flexibilities around Medicare coverage of telehealth, but most such flexibilities remain temporary. This brief answers key questions about the current scope of Medicare telehealth coverage, including both temporary and permanent changes adopted through legislation and regulation, and future policy considerations.

Examining the Potential Impact of Medicare’s New WISeR Model

A federal initiative to establish new prior authorization requirements in traditional Medicare, called the Wasteful and Inappropriate Service Reduction (WISeR) model, is likely to have only modest impact in its first year.

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. u003cbru003eu003cbru003eExplore 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.u003cbru003eu003cbru003eu003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022 data-type=u0022linku0022 data-id=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003eRelated:u003ca href=u0022https://www.kff.org/medicare/issue-brief/faqs-on-medicare-financing-and-trust-fund-solvency/u0022u003e FAQs on Medicare Financing and Trust Fund Solvencyu003c/au003eu003c/au003e

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  • Paying a Visit to the Doctor: Current Financial Protections for Medicare Patients When Receiving Physician Services

    Issue Brief

    This issue brief explains provisions in current law that shield beneficiaries from unexpected and confusing charges when they see physicians and practitioners—namely, the participating provider program, limitation on balance billing, and conditions on private contracting for doctors who opt out of Medicare or join “concierge” practices. It also analyzes the implications of modifying these provisions for beneficiaries, providers, and the Medicare program.

  • Medicare 101 Tutorial

    Interactive

    This tutorial was produced for kaiserEDU.org, a Kaiser Family Foundation website that ceased production in September 2013. The kaiserEDU.org tutorials are no longer being updated but have been made available on kff.org due to demand by professors who are using the tutorials in class assignments. You may search for other tutorials to view on kff.org. To download this or other tutorials, visit the tutorials archive page.  Slides are available for download using the “Download Slides” link within the…

  • Medicare Advantage Hospital Networks: How Much Do They Vary?

    Report

    This report takes an in-depth look at Medicare Advantage plans’ hospital networks. The analysis draws upon data from 409 Medicare Advantage plans serving beneficiaries in 20 diverse counties that together accounted for about one in seven (14%) Medicare Advantage enrollees nationwide in 2015. The report examines the size and composition of plans’ hospital networks, the variation across counties, the inclusion of Academic Medical Centers and NCI-Designated Cancer Centers, and the relationship between network size and…

  • What is Medicare’s Role in End-of-Life Care?

    News Release

    Medicare plays an integral role in end-of-life care, an issue that is emotionally-charged and easily politicized.  About three-quarters of the 2.5 million Americans who die each year are ages 65 and older, and covered by Medicare at the time of their death, yet policy issues related to Medicare and end-of-life care are often poorly understood. As policymakers consider whether and how Medicare should pay physicians and other health care professionals for talking to Medicare beneficiaries…

  • Medicare Part D in 2016 and Trends over Time

    Report

    This chartpack presents a summary of Part D enrollment, premiums, cost sharing, benefit design and other key trends in 2016 and changes over time. For 2016, the analysis finds that 40% of Part D enrollees are now in Medicare Advantage drug plans, and over half of all enrollees are in plans offered by just three firms. The chartpack also highlights some concerning trends in the Low-Income Subsidy market, with the fewest number of premium-free plans…

  • Medicare Part D Spending on the EpiPen Increased More than 1000 Percent from 2007 to 2014

    News Release

    As policymakers in Washington scrutinize the rising cost of the EpiPen auto-injector, a new analysis from the Kaiser Family Foundation shows that Medicare Part D spending for the potentially life-saving device increased by more than 1000 percent between 2007, the year after the Part D drug benefit took effect, and 2014, the most recent year for which data are available. The higher spending partly results from more Part D enrollees using EpiPens during that period,…

  • Few People Switch Medicare Advantage Plans Each Year, Raising Questions About Whether Seniors Have the Tools and Information They Need To Compare Plans  

    News Release

    A small share of Medicare Advantage enrollees switch plans each year, but those who do tend to pick plans with lower premiums and out-of-pocket limits than the plans they left behind, according to a new analysis by the Kaiser Family Foundation. Eleven percent of enrollees voluntarily switched from one Medicare Advantage plan to another between 2013 and 2014, the analysis finds, while another four percent were forced to change because their Medicare Advantage plan exited…

  • Policy Insight Examines a Key Barrier That Younger Medicare Beneficiaries with Disabilities Face in Getting Supplemental Insurance Coverage

    News Release

    In a new policy insight, the Kaiser Family Foundation’s Tricia Neuman and Juliette Cubanski examine a 1990 federal law that ensures that people age 65 and older are able to buy a Medigap policy when they sign up for Medicare, but denies younger Medicare beneficiaries with disabilities the same right unless they live in a state that requires it.

  • An Overview of Medicare

    Issue Brief

    This issue brief provides an overview of Medicare, the health insurance program for people ages 65 and over and younger people with long-term disabilities. The brief review the characteristics of people on Medicare, what Medicare covers, benefit gaps and supplemental coverage, beneficiaries' out-of-pocket health care spending, program spending and financing, payment and delivery system reform, and issues for the future of Medicare.