医疗保险D部分实施十年后农村药房面临的问题。

Q2 Medicine
Rural policy brief Pub Date : 2017-04-01
Fred Ullrich, Abiodun Salako, Keith Mueller
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引用次数: 0

摘要

目的。RUPRI农村卫生政策分析中心自2005年实施医疗保险D部分以来一直在监测农村独立药房的状况。在D部分的十年之后,我们在本简报中重新评估了与农村药房有关的问题,并可能最终挑战他们提供的服务。这一重新评估是基于对农村药剂师的调查反馈。主要发现:(1)农村药师表示,直接和间接报酬(DIR)费用和延迟的最大允许成本(MAC)调整这两项挑战在规模和紧迫性上都排名最高。近80%(79.8%)的受访者认为DIR费用是一个非常大的挑战,83.3%的受访者认为这是一个非常紧迫的挑战。78%的受访者表示,药品价格指标的更新速度不够快,无法反映药品批发成本的变化,这是一个非常大的挑战,79.7%的受访者表示这是一个非常紧迫的挑战。(2)医疗保险D部分仍然是农村药房关注的问题——58.8%的药剂师表示,作为D部分计划的网络外药房是一个非常大的挑战(另外29.0%的药剂师表示大的挑战),60.5%的药剂师表示这是一个非常直接的挑战(另外28.1%的药剂师表示中等直接)。(3)药房人员配备、来自连锁药店的竞争以及医疗补助患者的服务合同不太可能被认为是重大或紧迫的挑战。
本文章由计算机程序翻译,如有差异,请以英文原文为准。
Issues Confronting Rural Pharmacies after a Decade of Medicare Part D.

Purpose. The RUPRI Center for Rural Health Policy Analysis has been monitoring the status of rural independent pharmacies since the implementation of Medicare Part D in 2005. After a decade of Part D, we reassess in this brief the issues that concern rural pharmacies and may ultimately challenge their provision of services. This reassessment is based on survey responses from rural pharmacists. Key Findings: (1) Rural pharmacists indicated that two challenges--direct and indirect remuneration (DIR) fees, and delayed maximum allowable cost (MAC) adjustment--ranked highest on scales of both magnitude and immediacy. Nearly eighty (79.8) percent of respondents reported DIR fees as a very large magnitude challenge, with 83.3 percent reporting this as a very immediate challenge. Seventy-eight percent of respondents reported MACs not being updated quickly enough to reflect changes in wholesale drug costs as a very large magnitude challenge, with 79.7 percent indicating it as a very immediate challenge. (2) Medicare Part D continues to be a concern for rural pharmacies--58.8 percent of pharmacists said being an out-of-network pharmacy for Part D plans was a very large magnitude challenge (an additional 29.0 percent said large magnitude) and 60.5 percent said it was a very immediate challenge (an additional 28.1 percent said moderately immediate). (3) Pharmacy staffing, competition from pharmacy chains, and contracts for services for Medicaid patients were less likely to be reported as significant or immediate challenges.

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Rural policy brief
Rural policy brief Medicine-Medicine (all)
CiteScore
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