MD3 EVALUATING THE WILLINGNESS-TO-PAY OF MEDICARE BENEFICIARIES FOR PART D PLAN ASSISTANCE

Introduction: In response to reported difficulties in selecting a Medicare Part D prescription drug plan, we designed a patient-centered online Part D plan selection tool (CHOICE1.0) to simplify the selection process and to provide personalized, expert recommendations. Methods: This ethnographic comparative usability study observed 44 patients using the first version of the tool during Medicare 2016 Open Enrollment. Participants were observed as they chose their drug plan using Medicare.gov and 1 of 3 versions of CHOICE1.0 that varied in amount of expert guidance. Descriptive statistics were used to analyze exit survey data. The observations were video-recorded, and field notes were analyzed thematically. Results: Participants were significantly more satisfied with CHOICE1.0 for choosing a plan, understanding information, and ease of use compared to Medicare.gov . Those using expert versions of CHOICE1.0 were more likely to indicate their intention to switch plans than those using Medicare.gov , though they wanted to know the source and content. Conclusion: The more patient-centered prescription drug choice tool improved user experience and enabled users to choose plans more consistent with expert recommendations.

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Association Between Prescription Drug Insurance and Health Care Utilization Among Medicare Beneficiaries

Medical Care Research and Review ◽

10.1177/1077558716681920 ◽

2016 ◽

Vol 75 (2) ◽

pp. 153-174

Author(s):

G. Caleb Alexander ◽

Cuiping Schiman ◽

Robert Kaestner

Keyword(s):

Length Of Stay ◽

Medicare Part D ◽

Care Utilization ◽

Medicare Beneficiaries ◽

Medicare Current Beneficiary Survey ◽

Part D ◽

Drug Insurance ◽

Clinically Significant ◽

Instrumental Variables Approach ◽

Mean Charge

Medicare Part D was associated with reduced hospitalizations, yet little is known whether these effects varied across patients and how Part D was associated with length of stay and inpatient expenditures. We used Medicare claims and the Medicare Current Beneficiary Survey from 2002 to 2010 and an instrumental variables approach. Gaining drug insurance through Part D was associated with a statistically significant 8.0% reduction in likelihood of admission across conditions examined. Reductions were generally greater for younger, healthier, and male individuals. Across all conditions, mean length of stay decreased by 3.2% from a baseline of 5.1 days. Part D was associated with a 3.5% reduction in expenditures per admission, reflecting a decrease of $844 from a mean charge of $24,124 per admission prior to Part D. Thus, Part D was associated with statistically and clinically significant reductions in the probability of admission and length of stay for several common conditions.

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Meaningful use stage 2 e-prescribing threshold and adverse drug events in the Medicare Part D population with diabetes

Journal of the American Medical Informatics Association ◽

10.1093/jamia/ocv036 ◽

2015 ◽

Vol 22 (5) ◽

pp. 1094-1098 ◽

Cited By ~ 6

Author(s):

Christopher Powers ◽

Meghan Hufstader Gabriel ◽

William Encinosa ◽

Farzad Mostashari ◽

Julie Bynum

Keyword(s):

Adverse Drug Events ◽

Meaningful Use ◽

Medicare Part D ◽

Medicare Part ◽

Ambulatory Setting ◽

Diabetic Patients ◽

Medicare Beneficiaries ◽

Part D ◽

Use Stage ◽

Reduced Risk

Abstract Evidence supports the potential for e-prescribing to reduce the incidence of adverse drug events (ADEs) in hospital-based studies, but studies in the ambulatory setting have not used occurrence of ADE as their outcome. Using the “prescription origin code” in 2011 Medicare Part D prescription drug events files, the authors investigate whether physicians who meet the meaningful use stage 2 threshold for e-prescribing (≥50% of prescriptions e-prescribed) have lower rates of ADEs among their diabetic patients. Risk of any patient with diabetes in the provider’s panel having an ADE from anti-diabetic medications was modeled adjusted for prescriber and patient panel characteristics. Physician e-prescribing to Medicare beneficiaries was associated with reduced risk of ADEs among their diabetes patients (Odds Ratio: 0.95; 95% CI, 0.94-0.96), as were several prescriber and panel characteristics. However, these physicians treated fewer patients from disadvantaged populations.

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Use and spending on antineoplastic therapy (AT) in the Medicare population and the role of supplemental coverage.

Journal of Clinical Oncology ◽

10.1200/jco.2012.30.15_suppl.6060 ◽

2012 ◽

Vol 30 (15_suppl) ◽

pp. 6060-6060

Author(s):

Amy J. Davidoff ◽

Thomas Shaffer ◽

Ilene H. Zuckerman ◽

Naimish B. Pandya ◽

Bruce C. Stuart ◽

...

Keyword(s):

Linear Models ◽

Prescription Medication ◽

Self Report ◽

Cancer Site ◽

Newly Diagnosed ◽

Medicare Beneficiaries ◽

Part D ◽

Ongoing Research ◽

Factors Associated

6060 Background: Oral antineoplastic agents (OAA) represent a growing sector of cancer therapy. Prior studies of older adult cancer patients (pts) examined use of infused/ injected chemotherapy (IICT) covered by Medicare Part B. We examined trends in IICT and OAA use, and the effect of supplemental coverage on AT use and spending. Methods: We used Medicare Current Beneficiary Survey data (1997-2007). Newly diagnosed cancer pts were selected using ICD-9CM codes. IICT use was identified from Part B claims; OAAs were identified from self reported prescription medication events. Supplemental coverage and pt characteristics were assessed from administrative records and self-report. Total spending summed payments from all sources during the cancer diagnosis and subsequent year. Logistic regression examined factors associated with use of any and type of AT; Generalized Linear Models estimated factors associated with spending. Results: Of 1,836 newly diagnosed cancer pts 559 (31%) received AT; 395 (21%) used IICT and 253 (15%) used OAAs. Spending per user was $7,544(AT), $9,892 (IICT), and $1,535 (OAA). Supplemental coverage was associated with increased odds of AT use compared to no supplemental coverage (see Table). Cancer site and age were key predictors of spending among users. OAA spending increased during 2006-7 relative to 2004-5. Conclusions: AT use in Medicare beneficiaries is sensitive to the presence but not type of supplemental coverage. OAAs were used by a relatively large proportion of cancer pts receiving AT, although spending was less than for IICT during this largely pre-Part D period. With the growing number of relatively new OAAs, and more in the pipeline, monitoring the role of supplemental coverage, and particularly the role of Part D on access and spending is a critical area for ongoing research. [Table: see text]

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