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The Henry J. Kaiser Family Foundation

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.

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The Henry J. Kaiser Family Foundation

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.

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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.

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5.13.14 Medicare Event v2

How Well Are Seniors Making Choices Among Medicare’s Private Plans And Does It Matter? Briefing and Panel Discussion

The Kaiser Family Foundation will hold a policy briefing to examine how seniors and younger Medicare beneficiaries are negotiating their Medicare Advantage and Part D coverage options and consider the implications for them and for Medicare in the future.

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The Henry J. Kaiser Family Foundation

How are Seniors Choosing and Changing Health Insurance Plans?

This report summarizes first-hand accounts of seniors’ Medicare private plan decision making strategies, based on focus groups conducted in four cities. Seniors found the initial plan selection process overwhelming due to the volume of information they received and their inability to organize it. Few used the government’s online comparison tool, and those that did cite several shortcomings. Many relied on advice from sources they trust, including insurance agents, plan representatives, friends, family members, doctor’s offices and pharmacists. After they enroll in a plan, many seniors did not revisit their initial decision or review plan options without the strong provocation of a substantial increase in cost, change in coverage, or shift in personal health care needs. Moreover, they feared that a change in plans may disrupt their care, or lead to an unforeseen increase in out-of-pocket costs, and require them to learn new rules and requirements. They are doubtful they would end up in a plan that is appreciatively different or better for them. Overall, seniors preferred to have numerous choices in plans but would like personalized help and advice from experts to ease the process.

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Figure 1: Medicare Advantage Enrollment in 2014 Exceeds Projections by 6 Million Beneficiaries

Medicare Advantage: Take Another Look

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).

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The Henry J. Kaiser Family Foundation

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…

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The Henry J. Kaiser Family Foundation

Medicare Advantage: Take Another Look 

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

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The Henry J. Kaiser Family Foundation

Paying a Visit to the Doctor: Current Financial Protections for Medicare Patients When Receiving Physician Services

As the Congress continues to work on reforming Medicare payments for physician services, a new Kaiser Family Foundation brief examines key provisions in current law that help provide safeguards and financial protections for beneficiaries when they visit their doctor, and explains how potential changes could affect beneficiaries, providers, and the…

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The Henry J. Kaiser Family Foundation

May 13 Briefing: How Well Are Seniors Making Choices Among Medicare’s Private Plans And Does It Matter?

The typical Medicare beneficiary this year has 18 private Medicare Advantage plans and 35 stand-alone Part D drug plan options to consider, in addition to traditional Medicare. Medicare encourages seniors to make informed decisions with respect to their health coverage options when they first become eligible for Medicare, and to…

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