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The Henry J. Kaiser Family Foundation

Adding an Out-of-Pocket Spending Maximum to Medicare: Implementation Issues and Challenges

In an effort to simplify Medicare’s cost-sharing requirements, provide beneficiaries with catastrophic protection, and achieve program savings, some have proposed to restructure Medicare’s benefit design. Several recent proposals would create a unified deductible for Medicare Parts A and B, simplify cost-sharing requirements above the deductible, and add an annual limit on beneficiary out-of-pocket spending—a benefit feature typical of larger employer plans, but lacking in traditional Medicare. This issue brief describes the options for adding an out-of-pocket spending limit to Medicare and examines the operational issues that could arise in implementing both a uniform and an income-based out-of-pocket spending limit. Because the implementation of an income-related out-of-pocket maximum would pose somewhat greater complexity for Medicare, the operational issues associated with this approach are discussed in greater detail.

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Visualizing Health Policy: Physicians and Medicare

This infographic illustrates information about Medicare’s payment formula for physicians and about access to health care for people covered by Medicare.

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The Henry J. Kaiser Family Foundation

Financial Alignment Demonstrations for Dual Eligible Beneficiaries: A Look at CMS’s Evaluation Plan

This issue brief describes the Centers for Medicare and Medicaid Services’ plan to evaluate the financial alignment demonstrations, for beneficiaries dually eligible for Medicare and Medicaid via its contract with RTI International.

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The Henry J. Kaiser Family Foundation

What’s Trending in Health Care? Conservative Ideas

In his latest column for The Wall Street Journal’s Think Tank, Drew Altman cuts through the political debate and reviews how some ideas conservatives like are taking hold in the American health system.

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The Henry J. Kaiser Family Foundation

What’s Trending in Health Care? Conservative Ideas

What’s Trending in Health Care? Conservative Ideas In his latest column for The Wall Street Journal’s Think Tank, Drew Altman cuts through the political debate and reviews how some ideas conservatives like are taking hold in the American health system. All previous columns by Drew Altman are available online.

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The Henry J. Kaiser Family Foundation

Testimony: Income Security and the Elderly: Securing Gains Made in the War on Poverty

Senior Vice President Patricia Neuman testified before the U.S. Senate Special Committee on Aging as part of its hearing entitled Income Security and the Elderly: Securing Gains Made in the War on Poverty. As part of her testimony, she presented segments from a Foundation-produced video that highlights what it means to be old and poor in our country.

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Old and Poor: America's Forgotten

Old and Poor: America’s Forgotten

While the Census Bureau’s official poverty measure shows 9 percent of seniors nationally live in poverty, the share climbs to about one in seven seniors (15 percent) under the Bureau’s alternative Supplemental Poverty Measure, which takes into account out-of-pocket health expenses and geographic differences in the cost of living. Produced by the Kaiser Family Foundation, Old and Poor: America’s Forgotten provides a portrait of seniors who are living in poverty, in both urban and rural areas across the United States.

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The Henry J. Kaiser Family Foundation

Summary of Medicare Provisions in the President’s Budget for Fiscal Year 2015

On March 4, 2014, the Office of Management and Budget released President Obama’s budget for fiscal year (FY) 2015, which includes provisions related to federal spending and revenues, including Medicare savings. The President’s budget would use federal savings and revenues to reduce the federal debt and replace sequestration of Medicare and other federal programs for 2015 through 2024. This brief summarizes the Medicare provisions included in the President’s budget proposal for FY 2015.

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The Henry J. Kaiser Family Foundation

The Mystery of the Missing $1,200 Per Person: Can Medicare’s Spending Slowdown Continue?

This policy insight examines the unexpected drop in Medicare’s per-beneficiary spending projections and its implications for beneficiaries and the program’s future.

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Visualizing Income and Assets Among Medicare Beneficiaries: Now and in the Future

Visualizing Income and Assets Among Medicare Beneficiaries: Now and in the Future

This interactive tool describes the income, savings and home equity of people on Medicare in 2013, and in 2030. It allows users to break out the data by age, gender, race/ethnicity, marital status and education level, providing insight into the disparities within and across categories of beneficiaries.

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