Medicare Prescription Drug Plan Enrollees Report Less Positive Experiences Than Their Medicare Advantage Counterparts

Health Aff (Millwood). 2016 Mar;35(3):456-63. doi: 10.1377/hlthaff.2015.0816.

Abstract

Since 2006, Medicare beneficiaries have been able to obtain prescription drug coverage through standalone prescription drug plans or their Medicare Advantage (MA) health plan, options exercised in 2015 by 72 percent of beneficiaries. Using data from community-dwelling Medicare beneficiaries older than age sixty-four in 700 plans surveyed from 2007 to 2014, we compared beneficiaries' assessments of Medicare prescription drug coverage when provided by standalone plans or integrated into an MA plan. Beneficiaries in standalone plans consistently reported less positive experiences with prescription drug plans (ease of getting medications, getting coverage information, and getting cost information) than their MA counterparts. Because MA plans are responsible for overall health care costs, they might have more integrated systems and greater incentives than standalone prescription drug plans to provide enrollees medications and information effectively, including, since 2010, quality bonus payments to these MA plans under provisions of the Affordable Care Act.

Keywords: Managed Care - Medicare < Managed Care; Managed Care - Quality < Managed Care; Medicare; Patient experience; Quality Of Care.

Publication types

  • Comparative Study
  • Research Support, U.S. Gov't, P.H.S.

MeSH terms

  • Age Factors
  • Aged
  • Aged, 80 and over
  • Databases, Factual
  • Drug Prescriptions / economics*
  • Drug Prescriptions / statistics & numerical data
  • Female
  • Health Expenditures
  • Humans
  • Insurance Coverage / economics
  • Insurance, Pharmaceutical Services / economics*
  • Male
  • Managed Care Programs / economics
  • Managed Care Programs / statistics & numerical data
  • Medicare Part C / economics*
  • Medicare Part D / economics*
  • Patient Satisfaction / statistics & numerical data
  • Retrospective Studies
  • Sex Factors
  • Surveys and Questionnaires*
  • United States