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State Financing of the Medicare Drug Benefit:  New Data on the “Clawback”

State Financing of the Medicare Drug Benefit: New Data on the “Clawback”Beginning in 2006, states will be 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…

Prospects for Retiree Health Benefits as Medicare Drug Coverage Begins

Findings from the Kaiser/Hewitt 2005 Survey on Retiree Health BenefitsThe 2005 Kaiser/Hewitt survey of large businesses that provide retiree health benefits to their workers assesses their responses to the new Medicare drug benefit in 2006, their plans for the future, and the way these changes affect retirees. It also looks…

Medicare+Choice Withdrawals: Understanding Key Factors

To help understand why M+C plans have exited or limited their participation in the M+C program in recent years, this report presents an empirical analysis of the factors associated with plan withdrawals between 1999 and 2001. This analysis explores factors such as M+C payment levels, local market characteristics, and individual…

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.

Faces of Dually Eligible Beneficiaries: Profiles of People with Medicare and Medicaid Coverage

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.

Improving the Financial Accountability of Nursing Facilities

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.