The Impact of Medicare Part D on Medicare-medicaid Dual-eligible Beneficiaries' Prescription Utilization and Expenditures PDF Download
Are you looking for read ebook online? Search for your book and save it on your Kindle device, PC, phones or tablets. Download The Impact of Medicare Part D on Medicare-medicaid Dual-eligible Beneficiaries' Prescription Utilization and Expenditures PDF full book. Access full book title The Impact of Medicare Part D on Medicare-medicaid Dual-eligible Beneficiaries' Prescription Utilization and Expenditures by Anirban Basu. Download full books in PDF and EPUB format.
Author: Anirban Basu
Publisher:
ISBN:
Category : Elderly poor
Languages : en
Pages :
Get Book Here
Book Description
Features of Part D gave rise to broad concern that the drug benefit would negatively impact prescription utilization among the six million dual eligible beneficiaries, either during the transition from state Medicaid to Part D coverage, or in the long-run. At the same time, Part D contained other features, such as its auto-enrollment and premium subsidization policies, which were designed to safeguard utilization for this vulnerable group. Using national retail pharmacy claims, we examine the experience of dual eligibles during the first 18 months of Part D. We find no evidence that Part D adversely affected pharmaceutical utilization or out-of-pocket expenditures in the transition period, or in the 18 months subsequent to Part D implementation.
Author: Anirban Basu
Publisher:
ISBN:
Category : Elderly poor
Languages : en
Pages :
Get Book Here
Book Description
Features of Part D gave rise to broad concern that the drug benefit would negatively impact prescription utilization among the six million dual eligible beneficiaries, either during the transition from state Medicaid to Part D coverage, or in the long-run. At the same time, Part D contained other features, such as its auto-enrollment and premium subsidization policies, which were designed to safeguard utilization for this vulnerable group. Using national retail pharmacy claims, we examine the experience of dual eligibles during the first 18 months of Part D. We find no evidence that Part D adversely affected pharmaceutical utilization or out-of-pocket expenditures in the transition period, or in the 18 months subsequent to Part D implementation.
Author: Kathleen M. King
Publisher: DIANE Publishing
ISBN: 1437989349
Category : Medical
Languages : en
Pages : 21
Get Book Here
Book Description
To help defray out-of-pocket prescription drug costs for limited or low-income Medicare beneficiaries, the Medicare Part D outpatient prescription drug program offers a low-income subsidy (LIS) for eligible beneficiaries. In 2010, about 9.4 million beneficiaries received the LIS -- about 40%of the approx. 23 million Medicare Part D beneficiaries in that year. Most of the LIS beneficiaries received the full LIS, thus paying no premiums or deductibles as long as they enrolled in so-called "benchmark" stand-alone prescription drug plans (PDP). Benchmark PDPs are those plans with premiums at or below a specified benchmark for a given geographic region, calculated by the Centers for Medicare & Medicaid Services (CMS), the agency within the Dept. of Health and Human Services (HHS) that administers the Medicare program. Full LIS beneficiaries may also enroll in other Part D plans but must pay any difference between the premium of the plan in which they choose to enroll and the benchmark for their region. This report examines the features of benchmark PDPs and explores how the random reassignment process may affect beneficiaries' drug utilization. Tables. This is a print on demand report.
Author:
Publisher: DIANE Publishing
ISBN: 9781422396643
Category :
Languages : en
Pages : 14
Get Book Here
Book Description
Author: Susanne M. Kirchhoff
Publisher: Createspace Independent Publishing Platform
ISBN: 9781540349224
Category :
Languages : en
Pages : 70
Get Book Here
Book Description
The Medicare Prescription Drug, Improvement, and Modernization Act of 2003 (MMA, P.L. 108-173) established a voluntary, outpatient prescription drug benefit under Medicare Part D, effective January 1, 2006. Medicare Part D provides coverage through private prescription drugplans (PDPs) that offer only drug coverage, or through Medicare Advantage (MA) prescription drug plans (MA-PDs) that offer coverage as part of broader, managed care plans. Private drug plans participating in Part D bear some financial risk, though federal subsidies cover most program costs in an effort to encourage participation and keep benefits affordable. At a minimum, Medicare drug plans must offer a "standard coverage" package of benefits or alternative coverage that is actuarially equivalent to a standard plan. Plans also may offer enhanced benefits. Although all plans must meet certain minimum requirements, there can be significant differences among offerings in terms of benefit design, specific drugs included in formularies (i.e., list of covered drugs), cost sharing for particular drugs, or the level of monthlypremiums. In general, beneficiaries can enroll in a plan, or change plan enrollment, when they first become eligible for Medicare or during open enrollment periods each October 15 through December 7. For plan year 2016, there are between 19 and 29 PDPs in each of the nation's 34 PDP regions, as well as Medicare Advantage plans. Because sponsors are allowed to change planofferings from year to year, beneficiaries must review their annual choices carefully to select theplans that best meet their needs. A key element of the Part D program is enhanced coverage for low-income individuals. Personswith incomes up to 150% of the federal poverty level (FPL) and assets below set limits are eligible for extra assistance with Medicare Part D premiums and cost sharing. Individuals enrolled in both Medicare and Medicaid (so-called dual eligibles), and certain other low-incombeneficiaries, are automatically enrolled in no-premium plans, which are Part D plans that have premiums at or below specified levels. In 2015, about 39 million Medicare beneficiaries received prescription drug benefits through a PDP or an MA-PD, with almost one-third receiving a low-income subsidy. Another 2 million received drug assistance through a Part D-subsidized retiree health plan, and 8 million Medicare beneficiaries had separate, private drug coverage. Overall, about 88% of Medicare beneficiarieshad drug coverage through either PDP or MA-PD plans, retiree coverage, or private insurance ofcomparable scope. Total Part D expenditures were close to $90 billion in calendar year 2015. Medicare Part D has cost less than originally forecasted, due in part to lower-than-predicted enrollment and increased use of less expensive generic drugs. However, the Medicare Trustees project that spending on Part D benefits will accelerate over the next 10 years due to expectationof further increases in the number of enrollees, costs associated with the gradual elimination of the out-of-pocket cost coverage gap, changes in the distribution of enrollees among coverage categories, a slowing of the trend toward greater generic drug utilization, and an increase in the use and the prices of specialty drugs.
Author: Dooyoung Lim
Publisher:
ISBN:
Category :
Languages : en
Pages :
Get Book Here
Book Description
The Medicare Part D program enhanced Medicare beneficiaries ability to afford prescription drugs through reduced drug prices, thereby increasing their drug utilization rates. Considering potentially high price responsiveness of lower degree of necessity drugs, Part D is likely to induce higher consumption of improperly used prescription drugs, including inappropriate and off-label drugs, in Medicare enrollees. Yet little evidence exists about howand to what extentPart D might have an impact on these types of medication use of elderly Medicare recipients. This thesis using multi-year (2001-2010) data from the Medical Expenditure Panel Survey (MEPS) explores whether and how much Part D has influenced inappropriate and off-label drug use patterns among elderly Medicare beneficiaries. The difference-in-differences (DD) model was used for both analyses. The inappropriate drug use study found that Part D did not promote the use of Beers Criteria (BC) drugs among elderly Medicare beneficiaries; rather, there has been a decreasing trend in the use of BC drugs over time regardless of type of insurance coverage. Similarly, Part D did not promote off-label psychotherapeutic drug use among those who had newly obtained drug coverage through Part D. However, dual-eligibles increased off-label psychotherapeutic drug use after Part D went into effect, indicating that the transition of prescription drug costs from Medicaid to Medicare after Part D might have influenced the off-label psychotherapeutic drug use patterns of dual-eligibles. Both inappropriate and off-label drug use rates are remarkably high among elderly Medicare beneficiaries, suggesting that continuing clinical and policy efforts should be established to reduce non-proper use of prescription drugs among elderly Medicare enrollees in order to improve quality prescription drug therapies.
Author:
Publisher:
ISBN:
Category :
Languages : en
Pages : 508
Get Book Here
Book Description
Author: United States Government Accountability Office
Publisher: Createspace Independent Publishing Platform
ISBN: 9781976386305
Category :
Languages : en
Pages : 72
Get Book Here
Book Description
Since January 1, 2006, all dual-eligible beneficiaries-individuals with both Medicare and Medicaid coverage-must receive their drug benefit through Medicare's new Part D prescription drug plans (PDP) rather than from state Medicaid programs. GAO analyzed (1) current challenges in identifying and enrolling new dual-eligible beneficiaries in PDPs, (2) the Centers for Medicare & Medicaid Services' (CMS) efforts to address challenges, and (3) federal and state approaches to assigning dual-eligible beneficiaries to PDPs. GAO reviewed federal law, CMS regulations and guidance and interviewed CMS and PDP officials, among others. GAO also made site visits to six states to learn about the enrollment of dual-eligible beneficiaries from the state perspective.
Author: Leslie G. Aronovitz (au)
Publisher: DIANE Publishing
ISBN: 9781422306734
Category : Business & Economics
Languages : en
Pages : 88
Get Book Here
Book Description
On Jan. 1, 2006, Medicare began providing coverage for outpatient prescription drugs through its new Part D benefit. Beneficiaries who enroll in Part D may choose a drug plan from those offered by private plan sponsors under contract to the Centers for Medicare & Medicaid Serv. (CMS), which administers the Part D benefit. Beneficiaries have until May 15, 2006, to enroll in the Part D benefit & select a plan without the risk of penalties. This report reviews the quality of CMS's commun. on the Part D benefit. This report: examined 70 CMS publications to select 6 documents to review & evaluate the clarity of these texts; made 500 calls to the 1-800-MEDICARE help line; & evaluated the usability of the Medicare Web site. Illus.
Author: United States. Congress. Senate. Committee on Finance
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 322
Get Book Here
Book Description
Author: United States. Congress. House. Committee on Energy and Commerce. Subcommittee on Health
Publisher:
ISBN:
Category : Medical
Languages : en
Pages : 216
Get Book Here
Book Description
