Medicare

New & Noteworthy

What to Know About Pharmacy Benefit Managers and Federal Efforts at Regulation

The top three pharmacy benefit managers (PBMs) manage 79% of prescription drug claims on behalf of 270 million people. We look at the role PBMs play in influencing drug costs and access to medicines, as well as efforts to regulate them.

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.

Related: FAQs on Medicare Financing and Trust Fund Solvency

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  • Retiree Health VEBAs: A New Twist On An Old Paradigm

    Issue Brief

    This issue brief provides an overview of stand-alone Voluntary Employees' Beneficiary Association trusts, through which employers have been able to rid themselves of future obligations to pay retiree health benefits in exchange for making a significant payment to designed to approximate the projected cost of these benefits.

  • 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.

  • Medicare Part D 2008 Data Spotlight: Utilization Management

    Issue Brief

    This Medicare Part D data spotlight examines three common techniques used by Medicare stand-alone prescription drug plans in 2008 to manage enrollees’ use of formulary drugs, such as quantity limits, prior authorization, and step therapy rules. This is one in a series analyzing key aspects of the 2008 Medicare Part D prescription drug plan choices.

  • The Story of Medicare: A Timeline

    Video

    Written and produced by KFF staff, The Story of Medicare: A Timeline serves as a visual timeline of Medicare’s history, including the debate that led to its creation in 1965 and subsequent changes, such as the passage and repeal of the Medicare Catastrophic Coverage Act in the 1980s, the Medicare Modernization Act in 2003, and the Affordable Care Act.

  • Visualizing Health Policy: The Public’s Health Care Agenda for 2013

    Other Post

    This month’s Visualizing Health Policy infographic looks at the US public’s priorities for health care in 2013, including actions by state governments, Medicaid expansion, Medicare spending, and spending for specific types of public health activities. See the full-size infographic at The Journal of the American Medical Association The original public opinion poll is available here.

  • Medicare and the Federal Budget: Comparison of Medicare Provisions in Recent Federal Debt and Deficit Reduction Proposals

    Issue Brief

    This brief provides a side-by-side comparison of Medicare provisions included in broad-based packages to reduce the deficit and debt put forward by the President and the Chairmen of the House and Senate Budget Committees. In addition, this brief summarizes Medicare provisions included in other deficit- and debt- reduction proposals released since January 2012 and describes recent activities that pertain to Medicare and the federal budget, including Medicare’s role in the Affordable Care Act (ACA), the fiscal cliff and sequestration.

  • Medicare Spending Limits: Issues and Implications

    Issue Brief

    Several major deficit-reduction plans include provisions that would impose an explicit limit on the growth in Medicare spending. In general, such limits would trigger cuts if Medicare spending grows more rapidly than a target, such as the growth in the economy.