Voices of Beneficiaries: Early Experiences with the Medicare Drug Benefit

Presents findings from a survey that examines the enrollment decisions, experiences, and future concerns related to the prescription drug coverage of beneficiaries with the new Medicare prescription drug benefit. Part of a series of interviews

Medicare Part D: Simplifying the Program and Improving the Value of Information for Beneficiaries

Examines options for simplifying Medicare's prescription drug benefit, including streamlining benefit procedures and descriptions; further standardizing benefit parameters, especially cost-sharing rules; and modifying rules on plan formularies

Medicaid Managed Care in Florida: Federal Waiver Approval and Implementation

Florida's new Medicaid plan -- called the Managed Medical Assistance program -- will move nearly all of the state's Medicaid beneficiaries into managed-care plans. This new plan, approved in June 2013, is the final chapter in a Medicaid reform effort that is almost a decade old. Drawing on experiences from that decade of experimentation, the new plan incorporates significant consumer protections, some unique to Florida. Most of these protections establish the need for ongoing oversight and public input, creating opportunities for stakeholder monitoring and commen

Medicare Advantage: Options for Standardizing Benefits and Information to Improve Consumer Choice

Describes the complex choices Medicare Advantage enrollees face. Discusses whether providing better information and decision-support tools, limiting out-of-pocket expenses, or standardizing benefits and cost-sharing would lead to better-informed choices

An In-Depth Examination of Formularies and Other Features of Medicare Drug Plans

Provides a detailed assessment of the formularies, drug costs, and utilization management tools offered by the fourteen nationwide organizations that account for most of the stand-alone prescription drug plans

Medicare Prescription Drug Plans in 2008 and Key Changes Since 2006: Summary of Findings

Synthesizes findings from prior research on the scope and generosity of drug coverage under Medicare Part D, as well as on changes in drug coverage and costs since 2006. Looks at premiums, the coverage gap, tiered cost-sharing, and utilization management

The Medicare Part D Coverage Gap: Costs and Consequences in 2007

Analyzes data on Medicare Part D enrollees who reached the coverage gap and had to pay the full cost until they qualified for catastrophic coverage, who then stopped taking their medications or bought cheaper ones, and who received catastrophic coverage

Medicaid in Small Towns and Rural America: A Lifeline for Children, Families and Communities

Medicaid is a vital source of health coverage nationwide, but the program's role is even more pronounced in small towns and rural areas. Medicaid covers a larger share of nonelderly adults and children in rural and small-town areas than in metropolitan areas; this trend is strongest among children. Demographic factors have an impact on this relationship: rural areas tend to have lower household incomes, lower rates of workforce participation, and higher rates of disability— all factors associated with Medicaid eligibility. In addition, the role of Medicaid has increased in the past few years both in small towns and rural areas and in metropolitan areas, given the implementation of the Affordable Care Act (ACA) and more aggressive efforts to enroll children in Medicaid and the Children's Health Insurance Program (CHIP). Because Medicaid plays such a large role in small towns and rural areas, any changes to the program are more likely to affect the children and families living in small towns and rural communities

The Prescription Drug Safety Net: Access to Pharmaceuticals for the Uninsured

This background paper provides an overview of organized programs that provide access to prescription drug products for uninsured persons, with an emphasis on manufacturer-sponsored pharmacy assistance programs (PAPs) and the federal 340B drug pricing program. It summarizes the chief characteristics of these programs and reviews concerns regarding the reach and efficiency of these efforts. The paper begins with a brief examination of the number of people who lack insurance coverage for prescription drugs and discusses the influence of this gap in coverage on health status. The paper also describes informal mechanisms providers frequently use to help uninsured patients fill their prescriptions, such as sample dispensing. The paper briefly explores the impact of Medicare Part D on both manufacturer-sponsored PAPs and state pharmacy assistance programs that have not traditionally focused on the under-65 uninsured population

Cost Containment Strategies for Prescription Drugs: Assessing the Evidence in the Literature

Outlines various options for addressing prescription drug spending growth, including a description of each cost containment strategy, its use by private or public payers, and a discussion of known evidence about its effectiveness or cost saving potential