医疗保险D部分进入第四阶段:计划设计趋势,登记,以及该计划对受益人的影响。

Jack Hoadley, Kosali Simon
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引用次数: 3

摘要

目的:随着医疗保险D部分进入第五个年头,我们评估了市场的供应方是如何演变的,以及关于医疗保险药物覆盖如何影响消费者的研究表明了什么。方法:我们进行描述性数据分析,以探索医疗保险独立处方药计划的不同性质(在价格和非价格特征方面),检查与高入学率相关的特征,并显示2006年至2010年计划设计和入学率模式的随时间变化趋势。我们还审查了关于D部分对受益人获得药物的影响的现有证据,最后讨论了当前的政策问题。研究结果:医疗保险D部分在某些方面取得了成功,但仍存在一些值得关注的领域。尽管90%的医疗保险受益人现在有药品覆盖,这是一个成功的衡量标准,但努力仍在继续,以覆盖尚未注册的弱势群体。在该计划下,药物的使用(以及相对非专利药的使用)增加了,而自付费用却下降了。政策制定者继续质疑政府在一些领域的作用,比如直接与制药商谈判价格,以及限制提供的计划数量。数据分析的结果表明,除了其他因素外,保费的高增长,而按照某些标准,保险计划变得不那么慷慨了。原创性:本章汇集了医疗保险D部分独立药物覆盖市场提供的所有计划的数据,并展示了景观快速演变的新证据。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Medicare Part D turns four: trends in plan design, enrollment, and the impact of the program on beneficiaries.

Purpose: As Medicare Part D enters its fifth year, we assess how the supply side of the market has evolved and what research has shown about how Medicare drug coverage has affected consumers.

Methods: We conduct descriptive data analyses to explore the varied nature of Medicare standalone prescription drug plans (in terms of both price and non-price features), examine features associated with high enrollment, and show trends over time in both plan design and enrollment patterns from 2006 to 2010. We also review existing evidence about Part D's effects on drug access for beneficiaries and conclude with a discussion of current policy concerns.

Findings: Medicare Part D has been successful in certain ways, but several areas of concern remain. Although it is a measure of success that 90% of Medicare beneficiaries now have drug coverage, efforts continue to reach the vulnerable populations who are not yet signed up. Use of medications (and relative use of generics) has increased under the program, while out of pocket costs have fallen. Policymakers continue to question government's role in areas such as negotiating prices directly with pharmaceutical manufacturers and limiting the number of plans offered. Results from data analysis indicate, among other things, high growth in premiums, whereas plans have become less generous by certain measures.

Originality: This chapter brings together data on all plans offered in Medicare Part D standalone drug coverage market and shows new evidence on the landscape's rapid evolution.

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