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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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  • Low-Income Subsidies for the Medicare Prescription Drug Benefit: The Impact of the Asset Test

    Report

    This study assesses the impact of the requirement that low-income people with Medicare meet an asset test in order to receive additional help paying premiums and cost-sharing under the new Medicare drug benefit. Report (.pdf) American Journal of Managed Care Article: Who Will Be Denied Medicare Prescription Drug Subsidies Because of the Asset Test? (January 2006) (.pdf)

  • The Medicare Drug Benefit: Beneficiary Perspectives Just Before Implementation

    Poll Finding

    This comprehensive survey of seniors about the Medicare drug benefit finds that many seniors remain uncertain about how the new benefit will affect them and unsure about whether they will enroll. Seniors who say they understand the benefit well are more likely to report favorable views than those who do not. The survey examines in depth what seniors know and understand about the new benefit and what they think about its potential helpfulness. It was…

  • The Medicare Drug Benefit: Beneficiary Perspectives Just Before Implementation- Chartpack

    Poll Finding

    This chartpack highlights key results and trends from a comprehensive survey of seniors on their understanding of and views toward the Medicare drug benefit. The survey of 802 seniors was conducted in late October 2005, prior to the start of the benefit's open enrollment period, which runs from Nov. 15, 2005 to May 15, 2006. This survey is part of an ongoing effort to track seniors’ views on the Medicare prescription drug benefit, which has…

  • Medicare Prescription Drug Enrollment Update

    Issue Brief

    Medicare Drug Benefit Enrollment Update This enrollment update breaks down and explains the statistics related to enrollment under the new Medicare drug benefit and the separate low-income subsidy program that provides additional assistance. The enrollment update summarizes the latest enrollment figures released by the Centers for Medicare & Medicaid Services and the Social Security Administration and compares them with earlier enrollment projections. Issue Brief (.pdf)

  • Tracking Prescription Drug Coverage Under Medicare:  Five Ways to Look at the New Enrollment Numbers

    Issue Brief

    Tracking Prescription Drug Coverage Under Medicare: Five Ways to Look at the New Enrollment Numbers This new analysis, which assesses Medicare drug benefit enrollment statistics released Feb. 22 by the U.S. Department of Health and Human Services, examines five different approaches to understanding the Medicare drug coverage numbers: What share of the total Medicare population has creditable prescription drug coverage? What share of the total Medicare population is enrolled in a Medicare drug plan? How…

  • Voices of Beneficiaries: Early Experiences with the Medicare Drug Benefit

    Report

    The Medicare Modernization Act established a voluntary prescription drug benefit for Medicare’s elderly and disabled beneficiaries provided by private plans that is open to all beneficiaries. This paper focuses on the decision-making process and the factors that influence decisions about Medicare drug plans, as well as beneficiaries’ early experiences and future concerns related to their prescription drug coverage. It is based on in-depth interviews held in March 2006 with diverse beneficiaries in four cities: Baltimore;…

  • Medicare Part D 2008 Data Spotlight: Premiums

    Issue Brief

    This Medicare Part D data spotlight analyzes the premiums charged by the 1,824 stand-alone Medicare Part D plans that will be offered in markets across the country in 2008. The analysis finds premiums charged for Part D plans range widely, from $9.80 per month to $107.50 per month. The average monthly premium would increase from $27.39 in 2007 to $31.99 if enrollees remain in their current plans next year – a 17 percent increase. Nearly…

  • The Federal Government’s Authority To Regulate Advertising in Medicare

    Issue Brief

    This policy brief, prepared for the Kaiser Family Foundation by Vicky Gottlich at the Center for Medicare Advocacy, explains the Centers for Medicare & Medicaid Services’ legal authority to regulate advertising and other information issued by the private companies that contract with the government to provide Medicare benefits. The brief also suggests additional steps the agency could take to enhance consumer protections with respect to advertising and marketing practices under its current authority. Issue Brief…

  • The Diversity of Dual Eligible Beneficiaries: An Examination of Services and Spending for People Eligible for Both Medicaid and Medicare

    Issue Brief

    This issue brief analyzes linked Medicare and Medicaid data to examine dual eligibles' utilization and spending in both programs in 2007. As a group, dual eligibles are costly—with per capita Medicare and Medicaid spending over four times Medicare spending for other beneficiaries. However, a small share of dual eligibles account for most of the group's spending, and dual eligibles who are high cost to the Medicare program are generally not the same individuals who are…

  • Medicare Part D 2009 Data Spotlight: Ten Most Common Brand-Name Drugs

    Issue Brief

    This Data Spotlight focuses on Part D plan coverage of the ten brand-name drugs that were most commonly prescribed for Medicare beneficiaries in 2006 and lack generic equivalents in 2009. Findings are based on an analysis of data for the 44 unique, national and near-national stand-alone prescription drug plans. The list of the top ten brand-name drugs is based on the number of prescriptions filled in 2006 in all Part D plans. The list includes…