Eligibility For And Enrollment In Medicare Part D Medication Therapy Management Programs Varies By Plan Sponsor.

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  • Additional Information
    • Subject Terms:
    • NAICS/Industry Codes:
      525190 Other Insurance Funds
      524298 All Other Insurance Related Activities
      524292 Third Party Administration of Insurance and Pension Funds
      524128 Other Direct Insurance (except Life, Health, and Medical) Carriers
      524114 Direct Health and Medical Insurance Carriers
      524112 Direct group life, health and medical insurance carriers
      524210 Insurance Agencies and Brokerages
      923130 Administration of Human Resource Programs (except Education, Public Health, and Veterans' Affairs Programs)
    • Abstract:
      Medicare Part D prescription drug plans must offer medication therapy management to beneficiaries with multiple chronic conditions and high drug expenditures. However, plan sponsors have considerable latitude in setting eligibility criteria. Newly available data indicate that enrollment rates in medication therapy management among stand-alone prescription drug plans and Medicare Advantage drug plans averaged only 10 percent in 2012. The enrollment variation across plan sponsors-- from less than 0.2 percent to more than 57.0 percent--was associated with the restrictiveness of their eligibility criteria. For example, enrollment was 16.4 percent in plans requiring two chronic conditions versus 9.2 percent in plans requiring three, and 12.7 percent in plans requiring the use of any Part D drug versus 4.4 percent in plans requiring the use of drugs in specific classes. This variation represents inequities in access to medication therapy management across plans and results in missed opportunities for interventions that might improve therapeutic outcomes and reduce spending. The new Part D Enhanced Medication Therapy Management model of the Centers for Medicare and Medicaid Services has the potential to significantly increase the impact of medication therapy management by aligning financial incentives with improvements in medication use and encouraging innovation. [ABSTRACT FROM AUTHOR]
    • Abstract:
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    • Author Affiliations:
      1Professor of pharmaceutical health services research, University of Maryland School of Pharmacy, Baltimore
      2University of Maryland School of Pharmacy
      3University of Maryland, Baltimore
      4Assistant professor of pharmaceutical health services research, University of Maryland School of Pharmacy
      5Director of policy and research, Pharmaceutical Research and Manufacturers of America (PhRMA), Washington, D.C.
      6Senior economist, National Association of Chain Drug Stores, Arlington, Virginia
    • ISSN:
      0278-2715
    • Accession Number:
      10.1377/hlthaff.2016.0258
    • Accession Number:
      117963064
  • Citations
    • ABNT:
      STUART, B. et al. Eligibility For And Enrollment In Medicare Part D Medication Therapy Management Programs Varies By Plan Sponsor. Health Affairs, [s. l.], v. 35, n. 9, p. 1572–1580, 2016. Disponível em: . Acesso em: 23 out. 2019.
    • AMA:
      Stuart B, Hendrick FB, Xian Shen, et al. Eligibility For And Enrollment In Medicare Part D Medication Therapy Management Programs Varies By Plan Sponsor. Health Affairs. 2016;35(9):1572-1580. doi:10.1377/hlthaff.2016.0258.
    • APA:
      Stuart, B., Hendrick, F. B., Xian Shen, Mingliang Dai, Tom, S. E., Dougherty, J. S., & Miller, L. M. (2016). Eligibility For And Enrollment In Medicare Part D Medication Therapy Management Programs Varies By Plan Sponsor. Health Affairs, 35(9), 1572–1580. https://doi.org/10.1377/hlthaff.2016.0258
    • Chicago/Turabian: Author-Date:
      Stuart, Bruce, Franklin B. Hendrick, Xian Shen, Mingliang Dai, Sarah E. Tom, J. Samantha Dougherty, and Laura M. Miller. 2016. “Eligibility For And Enrollment In Medicare Part D Medication Therapy Management Programs Varies By Plan Sponsor.” Health Affairs 35 (9): 1572–80. doi:10.1377/hlthaff.2016.0258.
    • Harvard:
      Stuart, B. et al. (2016) ‘Eligibility For And Enrollment In Medicare Part D Medication Therapy Management Programs Varies By Plan Sponsor’, Health Affairs, 35(9), pp. 1572–1580. doi: 10.1377/hlthaff.2016.0258.
    • Harvard: Australian:
      Stuart, B, Hendrick, FB, Xian Shen, Mingliang Dai, Tom, SE, Dougherty, JS & Miller, LM 2016, ‘Eligibility For And Enrollment In Medicare Part D Medication Therapy Management Programs Varies By Plan Sponsor’, Health Affairs, vol. 35, no. 9, pp. 1572–1580, viewed 23 October 2019, .
    • MLA:
      Stuart, Bruce, et al. “Eligibility For And Enrollment In Medicare Part D Medication Therapy Management Programs Varies By Plan Sponsor.” Health Affairs, vol. 35, no. 9, Sept. 2016, pp. 1572–1580. EBSCOhost, doi:10.1377/hlthaff.2016.0258.
    • Chicago/Turabian: Humanities:
      Stuart, Bruce, Franklin B. Hendrick, Xian Shen, Mingliang Dai, Sarah E. Tom, J. Samantha Dougherty, and Laura M. Miller. “Eligibility For And Enrollment In Medicare Part D Medication Therapy Management Programs Varies By Plan Sponsor.” Health Affairs 35, no. 9 (September 2016): 1572–80. doi:10.1377/hlthaff.2016.0258.
    • Vancouver/ICMJE:
      Stuart B, Hendrick FB, Xian Shen, Mingliang Dai, Tom SE, Dougherty JS, et al. Eligibility For And Enrollment In Medicare Part D Medication Therapy Management Programs Varies By Plan Sponsor. Health Affairs [Internet]. 2016 Sep [cited 2019 Oct 23];35(9):1572–80. Available from: http://search.ebscohost.com/login.aspx?direct=true&site=eds-live&db=asn&AN=117963064&custid=s8280428