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Medicare and Medicaid News

Medicare Can Save Quick $5 Billion by Better Part D Choice for Low-Income Seniors

Researchers find simple way to strengthen Medicare drug program for low-income seniors and save government billions of dollars

June 3, 2014 – A $5 billion dollar savings for Medicare in the first year of making a simple and logical policy change sounds great to most seniors who worry about the financial pressure on their health care insurance program. Well, it’s possible, according to a new study that suggests changing the way Part D plans are selected for low-income beneficiaries eligible for a government subsidy.

The results of the new research from the University of Pittsburgh Graduate School of Public Health and funded by the National Institutes of Health (NIH) and the U.S. Department of Health and Human Services (HHS), will be published in the June issue of the journal Health Affairs.

Medicare Part D provides assistance to beneficiaries below 150 percent of the federal poverty level. In 2013, an estimated 10 million beneficiaries received subsidies, and 75 percent of the total Part D federal spending of $60 billion is for low-income enrollees. Since 2006, the government has randomly assigned low-income enrollees to stand-alone Part D plans, based upon the region in which they live.

"Random assignment is suboptimal because beneficiaries often are assigned to plans either not covering or charging higher costs for their medications," said Yuting Zhang, Ph.D., associate professor of health economics, Department of Health Policy and Management, Pitt Public Health, and the study's lead author. "We found that most people are not in the least expensive plans that satisfy their medication needs."

 

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Dr. Zhang and her colleagues say an "intelligent reassignment" that matches beneficiaries to their medication needs would yield substantial savings.

Using real data from 2008 and 2009 for a 5 percent random sample of all Medicare beneficiaries who qualified for the low-income subsidy program, Dr. Zhang and her team simulated potential medication costs to the beneficiaries and the government under each alternative plan available in the region.

They then compared the simulated costs with the actual costs of each plan. They found that if low-income enrollees were assigned to the least expensive plan instead of a random plan, the government and beneficiaries could save more than $5 billion in the first year.

In addition to the savings under the proposed change, beneficiaries would have fewer restrictions when filling their prescriptions. Some common restrictions used by Part D plans include quantity limits, prior authorization and step therapy.

The Pitt researchers noted that assigning beneficiaries to plans could be implemented relatively easily each year, with the largest savings in the first year but additional savings annually thereafter.

Additional authors on this study include Seo Hyon Baik, Ph.D., Pitt Public Health Pharmaceutical Economics Research Group, and Chao Zhou, Ph.D., formerly of Pitt Public Health.

The study was funded by the Agency for Healthcare Research and Quality and the National Institute of Mental Health.

About the University of Pittsburgh Graduate School of Public Health

The University of Pittsburgh Graduate School of Public Health, founded in 1948 and now one of the top-ranked schools of public health in the United States, conducts research on public health and medical care that improves the lives of millions of people around the world. Pitt Public Health is a leader in devising new methods to prevent and treat cardiovascular diseases, HIV/AIDS, cancer and other important public health problems. For more information about Pitt Public Health, visit the school's Web site at http://www.publichealth.pitt.edu. http://www.upmc.com/media

Another Report

Medicare Could Save Billions By Scrapping Random Drug Plan Assignment

By Julie Rovner, Kaiser Health News Blog, Capsules

June 2, 2014 - A new study finds that Medicare is spending billions of dollars more than it needs to on prescription drugs for low-income seniors and disabled beneficiaries.

In 2013, an estimated 10 million people who participate in the Medicare prescription drug program, known as Part D, received government subsidies to help pay for that coverage. They account for an estimated three-quarters of the program’s cost. Most of those low-income enrollees are randomly placed in a plan that costs less than the average for the region where the person lives.

But even though these are lower-cost plans, they often end up costing the government and the beneficiary more. If Medicare instead assigned those people to a drug plan based on the actual drugs they took, it could save those patients hassle and money, and potentially save the government billions of dollars, according to the study by researchers from the University of Pittsburgh.  The study appears in the June issue of the policy journal Health Affairs.

   • Read more, including reader comments, at Kaiser Health News

 

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