Unbiased Analysis of Today's Healthcare Issues
Today, the Supreme Court is deciding whether to let many of the provisions of the Affordable Care Act (a.k.a. ACA, a.k.a. Health Reform, a.k.a. Obamacare) stand. One of the key provisions is the individual mandate. The individual mandate requires all individuals to purchase health insurance. If you don’t buy health insurance, you must pay a…
Are elderly Medicare beneficiaries able to choose Part D health plans optimally? Many researchers may believe the answer is no. Certain elderly individuals (e.g., those with Alzheimer’s) may be cognitively impaired. Inertia is also a problem; switching plans is mentally taxing and involves a spending a significant amount of time researching plan alternatives. Nevertheless, a…
President Obama released a proposal last week to jump start the economy and reduce the deficit. The proposal includes many cuts to Medicare and increased cost sharing. Senators Coburn and Lieberman are supporting these cuts. Increased cost sharing is a common theme in Medicare, Medicaid, but also for other programs as well. For instance, the…
Many experts have claimed that increasing Medicare beneficiary’s access to prescription drugs through Medicare Part D is cost saving. Even if it does increase cost, by increasing patient adherence to various prescription drugs, Medicare could prevent certain expensive hospitalizations and emergency room visits. The only problem is that it doesn’t. According to Liu et al.…
Recent research from Avalere Health, LLC using Medicare Part D reveals some interesting trends. Overall, premiums for fee-for-service prescription drug plans (PDPs) increased by 3%. For beneficiaries who enrolled in a Top 10 plan, however, premiums actually decreased by 6%. This result was driven by a 12% decrease in premiums for the largest PDP, AARP…
Currently, most Medicare beneficiaries are able to receive coverage for prescription drugs under Medicare Part D. Some drugs, however, are still covered by Medicare Part B, which covers physician services. These drugs are generally those furnished incident to a physician’s service and are administered using durable medical equipment. To simplify coverage policy, Medicare is considering…
In an effort to standardize the provision of medication therapy management (MTM) within Medicare Part D, CMS has outlined specific requirements for Part D Plan MTM programs in 2010. The APhA’s Medication Therapy Management Digest (March 2010) reviews these requirements. MTM programs must: Enroll targeted beneficiaries using an opt-out method only (i.e., beneficiaries are automatically…