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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  • Summary of Final Regulations Implementing the New Medicare Prescription Drug Benefit

    Issue Brief

    This document summarizes the final regulations to implement the new Medicare prescription drug benefit. The regulations were published by the Centers for Medicare and Medicaid Services (CMS) as a final rule in the Jan. 28 Federal Register. It provides an overview that allows interested parties to obtain information about specific provisions of the law. The summary was prepared by Health Policy Alternatives Inc. on behalf of the Kaiser Family Foundation. Issue Brief (.pdf)

  • Medicare Part D Prescription Drug Plan Availability in 2013

    Fact Sheet

    This fact sheet contains 2013 state-specific summary data about available Medicare drug benefit options, including premium ranges and the number of plans available at no cost to qualifying beneficiaries. Fact Sheet (.pdf)

  • Kaiser Health Poll Report Survey: Seniors’ Early Experiences with the Medicare Prescription Drug Benefit

    Poll Finding

    Kaiser Health Poll Report Survey: Seniors' Early Experiences with the Medicare Prescription Drug Benefit This April 2006 tracking poll finds that most seniors enrolled in a Medicare drug plan are satisfied with their plan and are not having trouble getting the drugs they need. Most seniors enrolled in plans reported filling at least one prescription, and the vast majority of them -- more than 8 in 10 -- reported no problems getting their prescriptions filled.…

  • Medicare Part D 2008 Data Spotlight: Specialty Tiers

    Issue Brief

    This Medicare Part D data spotlight focuses on the use of specialty tiers for high-cost and injectible drugs in Medicare Prescription Drug Plans in 2008. It finds that the number of plans with specialty tiers has nearly doubled since 2006. It also looks at the drugs assigned to specialty tiers, the beneficiary cost sharing structure, and policy implications such higher out-of-pocket expenses and selection issues among beneficiaries who evaluate plans based on cost sharing. This…

  • The Nuts and Bolts of Medicare Premium Support Proposals

    Issue Brief

    In April 2011, as part of its 2012 budget resolution, the U.S. House included a proposal to reduce Medicare spending by transforming the program into a system sometimes called "premium support" or vouchers. Such an approach also has been a central element of other proposals by national leaders seeking to reduce the federal deficit and national debt. This Kaiser Family Foundation brief reviews the evolution of the premium support concept, examines key policy decisions and…

  • Medicare Part D 2011 Data Spotlight: The Coverage Gap

    Report

    This data spotlight examines the availability of gap coverage in the private Medicare Part D drug plans offered to beneficiaries in 2011, the first year of the phase-out of the gap, as required under the 2010 health reform law. The changes for 2011 include a 50 percent discount on brand-name drugs purchased during the gap in coverage, reducing an enrollee’s potential out-of-pocket costs in the gap from about $3,600 to $1,800. The analysis was conducted…

  • Integrating Care for Dual Eligibles: What Do Consumers Want?

    Event Date:
    Event

    Many deficit reduction plans have recognized the need to improve care for the 9 million beneficiaries dually eligible for Medicare and Medicaid. How do Medicaid and Medicare coordinate payment and care for people covered by both programs? Are Health and Human Services initiatives encouraging innovations to integrate care for dual eligible beneficiaries? What kind of programs are currently available? What do consumers think about different ways of getting care? What lessons for program design can…

  • The Olmstead Decision: Implications for Medicaid

    Issue Brief

    In June, 1999, the Supreme Court rule in Olmstead v L.C. that states were required to provide services to persons with disabilities in community settings rather than institutions, if certain conditions were met. This Policy Brief provides an overview of the Olmstead case, including the facts, the court ruling, and the disposition of the case. In addition, the brief describes the issues surrounding implementation and the implications this ruling could have for state Medicaid programs.…

  • Prescription Drug Coverage for Medicare Beneficiaries: A Side-by-Side Comparison

    Other Post

    This document, prepared by Health Policy Alternatives, Inc., provides a side-by-side comparison of five major federal proposals under consideration to provide outpatient prescription drug coverage to Medicare beneficiaries. It includes both a summary and a detailed comparison of the following major proposals: S. 357, The Medicare Preservation and Improvement Act of 2001 (Breaux/Frist I), S. 358, The Medicare Prescription Drug and Modernization Act of 2001 (Breaux-Frist II), H.R. 4680, The Medicare Rx 2000 Act (passed…

  • Women and Medicare

    Fact Sheet

    Medicare is a critical source of health insurance coverage for virtually all older women in the U.S. and for many younger women who have permanent disabilities. Because women have longer life expectancies than men, more than half (57%) of the people covered by the program are women. In 1999, there were 21 million women on Medicare 19 million ages 65 and over and another 2 million women under age 65 with disabilities who received Social…