At least half of new Medicare advantage enrollees had switched from traditional Medicare during 2006-11.

With ongoing interest in rising Medicare Advantage enrollment, we examined whether the growth in enrollment between 2006 and 2011 was mainly due to new beneficiaries choosing Medicare Advantage when they first become eligible for Medicare. We also examined the extent to which beneficiaries in traditional Medicare switched to Medicare Advantage, and vice versa. We found that 22 percent of new Medicare beneficiaries elected Medicare Advantage over traditional Medicare in 2011; they accounted for 48 percent of new Medicare Advantage enrollees that year.

Dx for a careful approach to moving dual-eligible beneficiaries into managed care plans.

Policy makers are moving rapidly to develop and test reforms aimed at doing a better job of managing the costs and care for people dually eligible for Medicare and Medicaid. This commentary underscores the importance of pursuing new initiatives to address care coordination and spending concerns. It then focuses on key issues raised by proposals that would shift dual-eligible beneficiaries into managed care plans.

Medicare doesn't work as well for younger, disabled beneficiaries as it does for older enrollees.

Medicare is not working as well for its eight million disabled beneficiaries under age sixty-five as it is for its older beneficiaries. We report on a 2008 survey that found significant differences between the two Medicare populations, with the younger group experiencing more problems of cost and access. Even with the Medicare Part D prescription drug program, the nonelderly disabled reported greater difficulty in affording medications, and more adverse health consequences as a result.

Prescription coverage, use and spending before and after Part D implementation: a national longitudinal panel study.

Background: In January 2006, 43 million Medicare beneficiaries became eligible for subsidized prescription coverage (Part D) through Medicare. To date, no longitudinal study has afforded information on beneficiaries' prescription coverage transitions and corresponding changes in prescription use and spending.

Objective: To evaluate changes in Medicare beneficiaries' prescription coverage, use and spending before and after Part D implementation, including comparison of those who enrolled in Part D with those who did not.

How much 'skin in the game' do medicare beneficiaries have? The increasing financial burden of health care spending, 1997-2003.

Rising health costs and an aging population present critical policy challenges. This paper examines the financial burden of out-of-pocket health spending among Medicare beneficiaries between 1997 and 2003. Over this period, median out-of-pocket spending as a share of income increased from 11.

Medicare prescription drug benefit progress report: findings from a 2006 national survey of seniors.

A national survey in 2006 found that Part D secured drug coverage for most seniors who were without it in 2005, prior to the Medicare drug benefit. Seniors without drug coverage in 2006 generally fell into two groups: those in relatively good health and those potentially difficult to reach. Compared with seniors covered through employer plans or the Department of Veterans Affairs, Part D enrollees had higher out-of-pocket spending and greater cost-related nonadherence.

Physician-patient communication about prescription medication nonadherence: a 50-state study of America's seniors.

Context: Understanding and improving the quality of medication management is particularly important in the context of the Medicare prescription drug benefit that took effect last January 2006.

Objective: To determine the prevalence of physician-patient dialogue about medication cost and medication adherence among elderly adults nationwide.

Design: Cross-sectional survey.

Status report on Medicare Part D enrollment in 2006: analysis of plan-specific market share and coverage.

The centerpiece of the Medicare Prescription Drug, Improvement, and Modernization Act of 2003 was the Part D drug benefit, provided through new stand-alone prescription drug plans (PDPs) and Medicare Advantage prescription drug (MA-PD) plans. We examine 2006 Part D enrollment data to analyze organization- and plan-level market share and enrollment by plan type, benefit design, and gap coverage. Ten organizations captured 72 percent of Part D enrollment, primarily in low-premium plans and those with name recognition.

Prescription drug coverage and seniors: findings from a 2003 national survey.

Beginning in 2006 the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) will offer pharmacy benefits to forty-two million Medicare beneficiaries nationwide. In a 2003 national survey of Medicare beneficiaries age sixty-five and older, more than one-quarter reported no prescription coverage, and nearly half of low-income seniors in some states lacked coverage. Wide coverage differences among states highlight implementation challenges and the need for tailored enrollment strategies.

Uncovering the health challenges facing people with disabilities: the role of health insurance.

Americans with disabilities have wide-ranging health care needs and face serious challenges in the health care system. This 2003 survey of 1,505 nonelderly adults with disabilities finds relatively large shares of people with disabilities reporting cost-related barriers to care. The study also reveals marked differences in cost-related experiences both between those with and without health insurance and across sources of coverage.

Large firms' retiree health benefits before Medicare reform: 2003 survey results.

This survey of large, private-sector employers offering retiree health benefits in 2003 provides a detailed baseline of private retiree health plans on the eve of the most sweeping changes to Medicare since its enactment. Total retiree health costs rose 13.7 percent in 2003, and average retiree contributions to premiums for employees age sixty-five and older retiring in 2003 rose 18 percent.

Prescription drug coverage and seniors: how well are states closing the gap?

As policymakers debate adding a drug benefit to Medicare, many states are attempting to provide drug coverage for low-income seniors through Medicaid and state-funded pharmacy assistance programs. This 2001 survey of seniors in eight states finds marked differences among states in the percentage of seniors with coverage and in the sources providing coverage. Among low-income seniors, a range of 20 percent (New York and California) to 38 percent (Michigan and Texas) lacked drug coverage.

Trends in Medicare supplemental insurance and prescription drug coverage, 1996-1999.

Medicare Current Beneficiary Survey (MCBS) Access to Care data indicate a five-percentage-point decline in the share of Medicare beneficiaries having Medigap coverage between 1996 and 1999; this was matched by a commensurate rise in the share enrolled in Medicare HMOs, contributing to an increase in the percentage with drug coverage. During this period, high-income beneficiaries, and to a lesser extent healthier and rural beneficiaries, experienced greater net declines in supplemental coverage and smaller relative gains in drug coverage, compared with others. By fall 1999, 38 percent of beneficiaries lacked drug coverage, based on point-in-time estimates.