Tag Archives: medicare

Problems with Epilepsy Drug Treatment for Older Adults

Expensive brand-name drugs are prescribed over older, less costly generics whose efficacy and risk profiles aren’t much different. Sometimes the financial issues involved are painfully obvious, such as when a drug company introduces a new, “improved” version of a medication that is merely a longer-acting version of the same chemical entity shortly before the patent expires on the original… Read More »

How did Part D affect mortality among women with breast cancer?

Ten years ago, Medicare began publicly financing and subsidizing the prescription drug program for seniors known as Part D. Individuals over age 65 with incomes below poverty are dually eligible for both Medicaid and Medicare, and full-benefit dual enrollees are automatically enrolled in a subsidized prescription drug plan with minimal co-payments. Turns out, this policy intervention may have played… Read More »

The Person-Centered Wellness Home: Reflections on a Conversation with Dr. Thelma Mielenz

With the mania of the presidential election in full tilt and the election just days away, it’s hard to have a rational public discussion about health care.  Supporters of the two presidential candidates have drawn a deep and divisive line (or rather a tectonic fissure) in the sand about health care reform.  This is due, in great part, to the bombastic, and ultimately… Read More »

The ACA vs. the doughnut hole: Medicare part D utilization and costs

President Obama’s Affordable Care Act (ACA) included provisions to gradually reduce the Medicare part D “doughnut hole” – a much-maligned gap in coverage that was an economizing feature of President Bush’s legislation. So, how have these changes affected drug use and spending by seniors? A new article in Medical Care provides insights. Under the standard part D benefit… Read More »

Gap in Payment for Medicare Cost Sharing Limits Access to Care for the Poor

Dual eligibility for Medicare and Medicaid is expected to improve access to care for low-income individuals who qualify for both programs, relative to eligibility for either program alone. Medicaid coverage of Medicare deductibles and co-payments can reduce the financial burdens that these cost sharing requirements may pose for low-income Medicare beneficiaries. These dual eligible beneficiaries… Read More »

Health care services use after Medicaid-to-dual transition for adults with mental illness

In 2013, there were 10.7 million people enrolled [PDF] in both Medicare and Medicaid. Dual eligibility depends on age, income, and disability. Dually enrolled beneficiaries are also responsible for a large share of program costs overall; 31% of Medicare fee-for-services spending for 18% of beneficiaries [PDF] who are dually enrolled. Given the additional health challenges [PDF] faced by dual eligibles, this… Read More »

All Falls Are Not Equal

All falls are not equal, nor is the financial impact of how Medicare defines fall-related injuries (FRI). In a new Medical Care article published ahead of print, I worked with colleagues at UCLA’s Fielding School of Public Health to explore whether Medicare expenditures associated with fall-related injuries (FRI) depend on how FRIs are identified in… Read More »

Measuring Cost-related Medication Burden

As readers of Medical Care are no doubt aware, prescription drug expenditures for Medicare beneficiaries are high – nearly $90 billion in 2012.  There is some evidence that Medicare Part D has reduced financial burdens, at least among some beneficiaries, but recent surveys suggest that around 4.4% of individuals ages 65 and older (including those not on… Read More »