09 Jun Assigning Low Income Medicare Enrollees to Least Expensive Plan May Save Billions
MedicalResearch.com Interview with:
Yuting Zhang, Ph.D.
Associate professor
Graduate School of Public Health Department of Health Policy and Management.
University of Pittsburgh
MedicalResearch: What are the main findings of the study?
Dr. Zhang: Since 2006, the government has randomly assigned low-income enrollees to stand-alone Part D plans, based upon the region in which they live. If low-income Medicare Part D 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.
MedicalResearch: What should clinicians and patients take away from your report?
Dr. Zhang: 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.
MedicalResearch: How did you arrive at these findings?
Dr. Zhang: We found these savings by 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. We simulated potential medication costs to the beneficiaries and the government under each alternative plan available in the region. We then compared the simulated costs with the actual costs of each plan.
MedicalResearch: Anything else you’d like to add?
Dr. Zhang: Assigning beneficiaries to plans could be implemented relatively easily each year, with the largest savings in the first year but additional savings annually thereafter.
Citation:
Yuting Zhang, Chao Zhou, and Seo Hyon Baik
Health Aff June 2014 33:6940–945; doi:10.1377/hlthaff.2013.1083
Last Updated on November 4, 2015 by Marie Benz MD FAAD