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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  • I’m under 65 and have a long-term disability. I am no longer working and receiving Social Security disability benefits. Am I eligible for Medicare?

    FAQs

    It depends on how long you have been receiving Social Security disability insurance (SSDI) payments. You are automatically enrolled in Medicare Part A and Part B after you have been receiving SSDI payments for two years. However, people with disabilities who have Amyotrophic Lateral Sclerosis (ALS) do not have to wait two years and are eligible for Medicare immediately upon collecting SSDI, and people with end-stage renal disease (ESRD) are eligible for Medicare three months…

  • What is a Medicare Accountable Care Organization? Can I enroll in one when I sign up for Medicare or during the Medicare Open Enrollment period?

    FAQs

    Medicare Accountable Care Organization (ACOs) are groups of doctors, hospitals, and other health care providers who voluntarily form partnerships to have collective responsibility for the quality and total cost of care delivered to their patients. ACOs are not health plans and you cannot “enroll” in them. Medicare may assign you to an ACO if your primary care doctor is in one, but you are still free to seek services from any Medicare provider inside or…

  • How can I find out if my doctor accepts Medicare?

    FAQs

    Most doctors in the United States accept Medicare. To find a list of doctors in your area who accept Medicare and agree not to bill you for more than the approved Medicare amount for your visit or procedure, go to Medicare’s Care Compare website , select “Doctors & clinicians” under the Provider Type dropdown menu, and look for providers noted as charging the Medicare-approved amount. If you do not have access to a computer, you…

  • The Public’s Policy Agenda for the 113th Congress: Briefing and Panel Discussion

    Event Date:
    Event

    As the 113th Congress is sworn in, and President Barack Obama begins his second term of office, a comprehensive new Kaiser Family Foundation/Robert Wood Johnson Foundation/Harvard School of Public Health survey queried the public about their priorities for, and views on, a wide range of health and health policy issues. These include issues that will preoccupy federal lawmakers, such as the role of Medicare in the deficit reduction debate, as well as issues currently being…

  • Health Care on the Brink of the Fiscal Cliff

    Event Date:
    Event

    The Alliance for Health Reform and the Kaiser Family Foundation present a November 16 briefing to discuss the components of this key policy crossroads with a particular emphasis on the implications for health programs and the health care industry. Automatic cuts would not apply to Medicaid, but Medicare providers would experience 2 percent payment cuts. The reductions would likely be larger for discretionary health programs, such as those funded as part of the National Institutes…

  • The Part D Experience: What are the Lessons for Broader Medicare Reform?

    Event Date:
    Event

    Launched in 2006, Medicare added a prescription drug benefit that relies entirely on private plans, while, for other benefits, beneficiaries have a choice between private health plans and traditional fee-for-service Medicare. As policymakers consider changes to Medicare that would give an even greater role to private health plans in caring for Medicare’s nearly 50 million seniors and people with disabilities, the Kaiser Family Foundation hosted a policy workshop to examine how the Part D experience…