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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  • An Update on the Clawback: Revised Health Spending Data Change State Financial Obligations for the New Medicare Drug Benefit

    Issue Brief

    An Update on the Clawback: Revised Health Spending Data ChangeState Financial Obligations for the New Medicare Drug Benefit States are obligated to finance part of the new Medicare prescription drug benefit via a monthly "clawback" payment to the federal government. This issue update analyzes the latest data and provides an overview of the state financing of the Medicare drug benefit. Revisions by the federal government due to updated data has resulted in an estimated net…

  • Kaiser Health Poll Report Survey: Seniors’ Early Experiences with Their New Medicare Drug Plans – June 2006

    Poll Finding

    Kaiser Health Poll Report Survey: Seniors' Early Experiences With Their New Medicare Drug Plans - June 2006 More than eight in 10 seniors who are enrolled in a Medicare drug plan are satisfied with their plan, although almost two in 10 say they encountered a major problem in using it, according to the latest Kaiser Family Foundation tracking survey of seniors' experiences under the new Medicare drug benefit. The survey of 1,585 seniors, including 623…

  • Cost Containment Strategies For Prescription Drugs: Assessing The Evidence In The Literature

    Report

    This report describes and reviews various options to address prescription drug spending growth, including a description of each cost-containment strategy, its use by private or public payers, and a discussion of known evidence about its effectiveness or cost-saving potential. It was prepared for the Kaiser Family Foundation by Jack Hoadley, Ph.D., of the Health Policy Institute at Georgetown University. Report (.pdf)

  • Medicare Managed Care (Spanish)

    Fact Sheet

    Medicare Managed Care (Spanish) Fact Sheet: The Medicare Program: Funcion de Medicare Para Latinos

  • Benefit Design and Formularies of Medicare Drug Plans: A Comparison of 2006 and 2007 Offerings

    Report

    This analysis provides a profile of the 2007 Medicare Part D stand-alone drug plans that are being offered to the program’s 43 million beneficiaries for 2007 and highlights some of the changes in plans between 2006 and 2007. It looks at premiums, covered drugs, the amount enrollees pay to fill a prescription, and other key features that would affect out-of-pocket costs and access to drugs for people with Medicare. The report describes the 1,875 stand-alone…

  • Medicare Payments and Beneficiary Costs for Prescription Drug Coverage

    Issue Brief

    This March 2007 issue brief, commissioned by the Kaiser Family Foundation, provides a basic introduction to the reimbursement system for private Medicare drug plans. It explains the system of plan bidding and payment, including the special provisions for low-income enrollees, and considers how aspects of the payment system may affect the total cost of the drug benefit over time, the cost of coverage for beneficiaries and the variety and quality of available plans. Mark Merlis…

  • Additional Help with Rx Drug Costs For Low-Income People on Medicare

    Other Post

    Additional Help with Prescription Drug Costs For Low-Income People on Medicare (For 2007 Benefits and Cost-Sharing) As of 2007, Medicare helps pay for outpatient prescription drugs. Medicare provides additional help with drug costs to beneficiaries who qualify based on low incomes and limited resources. The information below describes the different levels of assistance available to people who meet the eligibility requirements. People on Medicare Who Also Have Full Medicaid Benefits (Dual Eligibles) pay: No premium…

  • Papers on Issues For People With Medicare Raised By Proposed Drug Benefit Regulations

    Issue Brief

    Papers on Issues For People With Medicare Raised By Proposed Drug Benefit Regulations The Kaiser Family Foundation has commissioned a series of papers to explore key issues that may be of concern for Medicare beneficiaries as the new Medicare drug benefit is implemented. These papers focus on specific areas of potential concern for people with Medicare. In addition, the Foundation also has produced a timeline of upcoming important dates leading up to the implementation of…