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  • How Do M+C Plans Manage Pharmacy Benefits? Implications for Medicare Reform

    Report

    Understanding how Medicare+Choice (M+C) plans manage their drug benefits may generate important lessons for Medicare. This report, based on interviews with both national and regional managed care firms, provides an in-depth look at how plans have managed their M+C outpatient pharmacy benefits in recent years. Findings show that plans rely on a number of cost management strategies to constrain the growth in drug spending including formularies, tiered-copayments, mail-order benefits, and fixed caps or dollar limits…

  • An Update on the Clawback: Revised Health Spending Data Change State Financial Obligations for the New Medicare Drug Benefit

    Issue Brief

    An Update on the Clawback: Revised Health Spending Data ChangeState Financial Obligations for the New Medicare Drug Benefit States are obligated to finance part of the new Medicare prescription drug benefit via a monthly "clawback" payment to the federal government. This issue update analyzes the latest data and provides an overview of the state financing of the Medicare drug benefit. Revisions by the federal government due to updated data has resulted in an estimated net…

  • Kaiser Health Poll Report Survey: Seniors’ Early Experiences with Their New Medicare Drug Plans – June 2006

    Poll Finding

    Kaiser Health Poll Report Survey: Seniors' Early Experiences With Their New Medicare Drug Plans - June 2006 More than eight in 10 seniors who are enrolled in a Medicare drug plan are satisfied with their plan, although almost two in 10 say they encountered a major problem in using it, according to the latest Kaiser Family Foundation tracking survey of seniors' experiences under the new Medicare drug benefit. The survey of 1,585 seniors, including 623…

  • Benefit Design and Formularies of Medicare Drug Plans: A Comparison of 2006 and 2007 Offerings

    Report

    This analysis provides a profile of the 2007 Medicare Part D stand-alone drug plans that are being offered to the program’s 43 million beneficiaries for 2007 and highlights some of the changes in plans between 2006 and 2007. It looks at premiums, covered drugs, the amount enrollees pay to fill a prescription, and other key features that would affect out-of-pocket costs and access to drugs for people with Medicare. The report describes the 1,875 stand-alone…

  • Medicare Payments and Beneficiary Costs for Prescription Drug Coverage

    Issue Brief

    This March 2007 issue brief, commissioned by the Kaiser Family Foundation, provides a basic introduction to the reimbursement system for private Medicare drug plans. It explains the system of plan bidding and payment, including the special provisions for low-income enrollees, and considers how aspects of the payment system may affect the total cost of the drug benefit over time, the cost of coverage for beneficiaries and the variety and quality of available plans. Mark Merlis…

  • Why Consumer Issues Are Rising on the Health Agenda

    News Release

    In his latest column for The Wall Street Journal’s Think Tank, Drew Altman examines the trends that may be leading to a rise in consumer cost issues on the health agenda. All previous columns by Drew Altman are available online.

  • Medicare Part D at Ten Years: The 2015 Marketplace and Key Trends, 2006-2015

    Report

    Since 2006, Medicare beneficiaries have had access through Medicare Part D to prescription drug coverage offered by private plans, either stand-alone prescription drug plans (PDPs) or Medicare Advantage prescription drug plans (MA-PD plans). Now in its tenth year, Part D has evolved due to changes in the private plan marketplace and the laws and regulations that govern the program. This report presents findings from an analysis of the Medicare Part D marketplace in 2015 and…

  • Medicare Part D: A First Look at Plan Offerings in 2016

    Issue Brief

    During the Medicare open enrollment period, beneficiaries have the opportunity to enroll in a plan that provides Part D prescription drug coverage, either a stand-alone prescription drug plan (PDP) to supplement traditional Medicare, or a Medicare Advantage drug plan. This issue brief provides an overview of the 2016 PDP marketplace, focusing on key changes from 2015, based on analysis of data from the Centers for Medicare & Medicaid Services. It presents analysis of PDP availability,…