Medicare

The Affordable Care Act, Medicare Costs, and Retirement Security

The brief’s key findings are: The 2010 Affordable Care Act (ACA) included roughly 165 provisions to improve Medicare’s finances. The Medicare Trustees Report, which reflects the ACA provisions, shows dramatically lower cost projections for Medicare in the future. The Medicare actuaries also produce alternative projections assuming that the legislated restraints on growth in payments to health providers are […]

Medicare and the Future of Retirement Security

President Bush’s failed effort to privatize part of the Social Security program received a lot of attention from the media during the first half of 2005. Congressional efforts to begin privatizing the Medicare program over the last ten years have received far less attention. This absence of media attention may be one of the reasons […]

The High Stakes Struggle Over the Future of Medicare

Following the passage of the Medicare Modernization Act (MMA) of 2003, the future of Medicare is less clear than at any time since its inception almost 40 years ago. Medicare policy regarding financing coverage and delivery mechanisms has been the object of intermittently fierce political debate and maneuvering since 1995 when a conservative Republican majority […]

The 2016 Medicare Trustees Report: Is Medicare Doomed?

The June 22 release of the annual Medicare Trustees Report has, as usual, elicited conflicting responses. Some have focused on the positive—Medicare spending per enrollee has continued to grow at a historically slow rate—while others have emphasized the negative — the Medicare Hospital Insurance Trust Fund is now projected to run out of resources in […]

Medicare Help At Home

Nine million community-dwelling Medicare beneficiaries—about one-fifth of all beneficiaries—have serious physical or cognitive limitations and require long-term services and supports (LTSS) that are not covered by Medicare. Nearly all have chronic conditions that require ongoing medical attention, including three-fourths who have three or more chronic conditions and are high-need, high-risk users of Medicare covered services. […]

The U.S. Health Care Crisis Five Years After Passage of the Affordable Care Act A Data Snapshot

Despite passage of the Affordable Care Act in 2010, the U.S. health care crisis continues. While coverage has been expanded, the reform will leave 27 million people uninsured in 2024, according to the Congressional Budget Office. Much of the new coverage is of low actuarial value with high cost-sharing requirements, creating barriers to access. Choice […]

Report: Older Adult Population Growth Surges in Certain States

The pressure that the aging of America places on the nation is not evenly distributed among all states, according to a new report on healthiest states from the United Health Foundation and American Public Health Association. By 2030, it’s projected that more than 20 percent of the population will be age 65 and older, up […]

Deductibles cause sick patients to reduce beneficial care

Measuring consumer responsiveness to medical care prices is a central issue in health economics and a key ingredient in the optimal design and regulation of health insurance markets. We study consumer responsiveness to medical care prices, leveraging a natural experiment that occurred at a large self-insured firm which forced all of its employees to switch […]

Medicare Advantage Members’ Expected Out-Of-Pocket Spending For Inpatient And Skilled Nursing Facility Services

Inpatient and skilled nursing facility (SNF) cost sharing in Medicare Advantage (MA) plans may reduce unnecessary use of these services. However, large out-of-pocket expenses potentially limit access to care and encourage beneficiaries at high risk of needing inpatient and postacute care to avoid or leave MA plans. In 2011 new federal regulations restricted inpatient and […]

Health Affairs Article: At Least Half of New Medicare Advantage Enrollees Had Switched From Traditional Medicare During 2006-11

In an article in Health Affairs, Gretchen A. Jacobson and Patricia Neuman of the Kaiser Family Foundation and independent consultant Anthony Damico examined whether the 2006-2011 growth in private Medicare Advantage plans was due primarily to new beneficiaries choosing Medicare Advantage from the onset of their eligibility, or because beneficiaries enrolled in traditional Medicare were making […]

High-Cost Patients Had Substantial Rates Of Leaving Medicare Advantage And Joining Traditional Medicare

Medicare Advantage payment regulations include risk-adjusted capitated reimbursement, which was implemented to discourage favorable risk selection and encourage the retention of members who incur high costs. However, the extent to which risk-adjusted capitation has succeeded is not clear, especially for members using high-cost services not previously considered in assessments of risk selection. We examined the […]

MACRA: New Opportunities For Medicare Providers Through Innovative Payment Systems

Today, almost 60 million Americans are covered by Medicare — and 10,000 become eligible for Medicare every day. For many years, Medicare was primarily a pure fee-for-service (FFS) payment system that paid health care providers based on the volume of services they delivered, not the value of those services. Over time, this contributed to increased […]