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Data Note: Medicare Advantage Enrollment, by Firm, 2015

A number of potential mergers and acquisitions between large firms that offer health insurance have been reported in the press. These mergers could affect consumers in the individual market, enrollees in the new federal and state Marketplaces, employees with employer-sponsored insurance, as well as people covered by public programs such as Medicare. This Data Note examines the Medicare Advantage market share of large firms that have reportedly engaged in merger and acquisition discussions: Aetna, Anthem, Cigna, Humana, and UnitedHealthcare.

Medigap Enrollment Among New Medicare Beneficiaries: How Many 65-Year Olds Enroll In Plans With First-Dollar Coverage?

On March 26, 2015, the House of Representatives passed H.R. 2, the Medicare Access and CHIP Reauthorization Act of 2015, which would replace the Sustainable Growth Rate (SGR) formula, among other changes; the bill is currently pending in the U.S. Senate. H.R. 2 includes a provision that would prohibit Medicare supplemental insurance (Medigap) policies from covering the Part B deductible for people who become eligible for Medicare on or after January 1, 2020. This data note looks at the number and share of “new” Medicare beneficiaries who would be affected by the Medigap provision in H.R. 2, if it had been implemented in 2010, using the most current data sources available, and examines trends in Medigap enrollment among new beneficiaries since 2000.

Demonstrations to Improve the Coordination of Medicare and Medicaid for Dually Eligible Beneficiaries: What Prior Experience Did Health Plans and States Have with Capitated Arrangements?

This report examines the Center for Medicare and Medicaid Services (CMS) financial alignment demonstration for beneficiaries dually eligible for Medicare and Medicaid, with a focus on the extent to which participating states and health plans have prior experience with capitated managed care arrangements under Medicare or Medicaid, and specifically for this population. Under these capitated financial alignment demonstrations, health plans contract with the state and CMS (a three-way contract) to provide both Medicare and Medicaid benefits to dually eligible beneficiaries. These demonstrations aim to improve the quality of care and the coordination of benefits for people dually eligible for Medicare and Medicaid. The report finds considerable variation in the experience of states and health plans participating in these demonstrations, and discusses the potential implications for beneficiaries and plan oversight.

Medigap and the Medicare “Doc Fix”

The House-passed legislation to repeal the Medicare Sustainable Growth Rate (SGR) includes a provision that would prohibit Medicare supplemental insurance (Medigap) policies from covering the Part B deductible for people who become eligible for Medicare beginning in 2020. A new Kaiser Family Foundation Data Note explores the implications of this…

Generations: Medicare at 50 Years

Published in a special Summer 2015 edition of the journal Generations on Medicare’s 50th anniversary, these six articles by Kaiser Family Foundation staff reflect on Medicare’s history, evolution and future, including a look at lessons and challenges, the Medicare and Medicaid partnership, coverage, the role of private plans, Medicare’s role for women, and the public opinion about the program. Foundation Senior Vice President Tricia Neuman served as co-editor, along with National Coalition on Health Care President and CEO John Rother. The articles are available courtesy of the American Society on Aging, which publishes Generations.

What Do We Know About Health Care Access and Quality in Medicare Advantage Versus the Traditional Medicare Program?

As the number of Medicare Advantage enrollees continues to climb, there is growing interest in understanding how the care provided to Medicare beneficiaries in Medicare Advantage plans differs from the care received by beneficiaries in traditional Medicare. This literature review of more than 40 studies synthesizes the evidence to date comparing access and quality for beneficiaries in Medicare Advantage plans and traditional Medicare.

How Do Quality and Access Compare In Medicare Advantage Versus Traditional Medicare?

Today a record three in 10 Medicare beneficiaries are enrolled in Medicare Advantage health plans, mainly HMOs and PPOs, which are paid by the government to provide Medicare benefits to their enrollees. Given the projected rise in Medicare Advantage enrollment, an important question for both consumers and policymakers is how…

Medicare Advantage 2015 Data Spotlight: Overview of Plan Changes

This issue brief analyzes the number and variety of Medicare Advantage plan choices available to beneficiaries in 2015. It describes trends in number of Medicare Advantage plans, plan premiums, and plan quality ratings, including changes in prescription drug coverage and limits on out-of-pocket expenses. This spotlight is part of a series of spotlights tracking key changes in the Medicare Advantage program.

Health Affairs Article: At Least Half of New Medicare Advantage Enrollees Had Switched From Traditional Medicare During 2006-11

In an article in Health Affairs, researchers from the Kaiser Family Foundation counter the popular misperception that the steady rise in Medicare Advantage enrollment has been driven by members of the Baby Boom generation overwhelmingly choosing the private plans as they become eligible for Medicare. Their study examines the 2006-2011 growth in Medicare Advantage enrollment and finds that a majority of new enrollees in Medicare Advantage in each year were, in fact, seniors switching from traditional Medicare.

New Data Spotlight Tracks Rising Enrollment in Medicare Advantage Plan

A new brief from the Kaiser Family Foundation documents the continuing climb in Medicare Advantage plan enrollment, even at a time when payments to such plans are being reduced under the Affordable Care Act. Despite spending reductions enacted in the ACA to reduce historical overpayments to Medicare Advantage plans, from…