Congressional debates about the Medicare Sustainable Growth Rate (SGR) raise questions about whether doctors are willing to see Medicare patients. This issue brief examines multiple data sources to assess beneficiaries’ access to physicians, particularly vulnerable beneficiaries with greater health needs and other disadvantages. It examines the share of doctors who are participating physicians as well as those who have opted-out of the Medicare program to privately contract with Medicare patients. It includes State analyses of rates of physicians who are accepting new Medicare patients as well as patients with private health insurance and Medicaid.
MedicareSee more about Medicare
- view as grid
- view as list
This June 10 briefing looked at Medicare Advantage and changes affecting it, including revised calculations of payments from CMS, and the Affordable Care Act’s reduced payments to Medicare Advantage plans. Speakers discussed how Medicare Advantage plans are expected to respond to payment changes; if quality bonus payments created significant changes in patient care or plan choices; and what implications could these decisions have on beneficiaries with regard to premiums, benefits and more.
This Policy Insight explores possible explanations for the continued rise in Medicare Advantage enrollment between 2010 and 2013 in spite of a projected decrease following payment changes in the Affordable Care Act (ACA).
An Analysis of the Share of Medicare Beneficiaries Who Would Benefit from an Annual Out-of-Pocket Maximum under Traditional Medicare Over Multiple Years
This analysis examines the share of Medicare beneficiaries who would be helped over time if the program were to add a limit on out-of-pocket spending to traditional Medicare. This analysis was conducted jointly with the Medicare Payment Advisory Commission (MedPAC) in response to a request made during a Feb. 26, 2013 hearing of the House Ways and Means’ Subcommittee on Health.
This brief examines the role of Medicare and Medicaid in the lives of dually eligible beneficiaries – low-income seniors and younger adults with disabilities who are eligible for both programs – through personal profiles. It includes a glossary of eligibility and service delivery system terms and state-level enrollment and expenditure data for dual eligibles.
This report examines nursing facility expenditures to assess relative spending increases in areas such as nursing services, administrative costs, and profits. Using California as a case study, it explores reimbursement by cost category and a standard medical loss ratio (MLR) as potential policy options to improve nursing facility financial accountability and care quality.
Foundation Senior Vice President Tricia Neuman testified June 26, 2013 before the House Energy and Commerce Committee Subcommittee on Health about Medicare’s benefit design, and the implications of possible changes for beneficiaries, other stakeholders, and program spending.
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…
A new Kaiser Family Foundation report examines the current role and future outlook of employer-sponsored retiree health benefits for pre-65 and Medicare-eligible retirees. Retiree Health Benefits At the Crossroads reviews recent trends and developments in employer-sponsored retiree health coverage and examines the impact of recent legislation, such as the Medicare…
In the latest post in the Policy Insights series, Tricia Neuman and Gretchen Jacobson examine the surprising growth in Medicare Advantage enrollment following payment reductions included in the Affordable Care Act. Previous columns in the Policy Insights series are also available on kff.org.