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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.

Medicare Advantage 2013 Spotlight: Enrollment Market Update

This Data Spotlight provides an overview of Medicare Advantage enrollment patterns in March 2013, and examines variations by plan type, state, and firm. It also analyzes trends in premiums paid by beneficiaries enrolled in Medicare Advantage plans, including variations by plan type, and describes the out-of-pocket limits and prescription drug coverage in the Part D “donut hole” provided by the plans in 2013.

Medicare’s Role for Older Women

This fact sheet, Medicare’s Role for Older Women, discusses the characteristics of female Medicare beneficiaries, their health care needs, the structure of Medicare including cost-sharing requirements, and anticipated changes due to health reform.

The Future of Medicare Advantage: Are We on the Right Path?

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.

Visualizing Health Policy: The Role of Medicaid and Medicare in Women’s Health Care

This month’s Visualizing Health Policy infographic provides information about the role of Medicaid and Medicare in women’s health care: the proportion of US women who are covered by Medicaid and Medicare; how women comprise the majority of those covered by the Medicaid and Medicare programs and the majority of those receiving long-term services and supports (such as home health care); how women on Medicaid are poorer and sicker than women with private coverage; how Medicaid is a primary payer for women’s reproductive health services; and how women on Medicare spend more than their male counterparts on medical care and also have higher rates of health problems and social challenges.