Examining the Value of Subsidies of Health Plans and Cost-Sharing for Prescription Drugs in the Health Insurance Marketplace
The Affordable Care Act (ACA) initiated health insurance exchanges, or marketplaces, with health plans offering subsidies for plan members, to help individuals, families, and small businesses find health plans that fit their specific needs. By the end of the first open enrollment period, more than 8 million Americans selected qualified health plans through the ACA-initiated health insurance marketplace, and by February 2015, more than 10 million people enrolled and paid for health coverage through those plans in these marketplaces. Under state and federal rules and regulations, the ACA allowed insurers to offer a variety of well-defined health insurance plans and compete through the marketplace.
Health Plan Subsidies, Prescription Drugs, and Cost
The cost of cancer care in the United States continues to rise, in part as a result of the aging population and improvements in diagnosis, treatment, and survival. These costs are projected to reach $173 billion in 2020, representing a 39% increase from 2010
Implementing Payment Reform in Oncology: Benefits and Challenges
Patient-Reported Outcomes in Oncology Drug Labeling in the United States: A Framework for Navigating Early Challenges
Alan L. Shields, PhD, Yanni Hao, PhD, Meaghan Krohe, PhD, Andrew Yaworsky, Iyar Mazar, MA, Catherine Foley, MPH, MA, Faisal Mehmed, MD, Denise Globe, PhD
Junling Wang, PhD, Ya-Chen Tina Shih, PhD, Yolanda Qin, Theo Young, BS, Zachary Thomas, MS, MBA, Christina A. Spivey, PhD, David K. Solomon, BSc, PharmD, Marie Chisholm-Burns, PharmD, MPH, MBA, FCCP, FASHP, J. Warren Salmon, PhD
In a 2013 report, the IMS Institute for Healthcare Informatics estimated that the United States spent more than $213 billion on unnecessary medical expenses as a result of irresponsible medication use.
Is It Time to Revisit Medicare Part D?
Effects of Medicare Part D on Disparity Implications of Medication Therapy Management Eligibility Criteria
Marie Chisholm-Burns, PharmD, MPH, MBA, FCCP, FASHP, William C. Cushman, MD, Samuel Dagogo-Jack, MD, FRCP, JoEllen Jarrett Jamison, BS, Liyuan Li, PhD, Yanru Qiao, MS, Ya-Chen Tina Shih, PhD, Christina A. Spivey, PhD, Jim Y. Wan, PhD, Junling Wang, PhD, Shelley I. White-Means, PhD
Previous studies have shown that there were greater racial and ethnic disparities among individuals who were ineligible for medication therapy management (MTM) services than among MTM-eligible individuals before the implementation of Medicare Part D in 2006.
Medication Therapy Management, Medicare, and Disparities in Population Health
Offering Lung Cancer Screening to High-Risk Medicare Beneficiaries Saves Lives and Is Cost-Effective: An Actuarial Analysis
Ellynne Dec, ASA, MAAA, Claudia I. Henschke, PhD, MD, David F. Yankelevitz, MD, Rowena Yip, MPH, Bruce Pyenson, FSA, MAAA
By a wide margin, lung cancer is the most significant cause of cancer death in the United States and worldwide. The incidence of lung cancer increases with age, and Medicare beneficiaries are often at increased risk. Because of its demonstrated effectiveness in reducing mortality, lung cancer screening with low-dose computed tomography (LDCT) imaging will be covered without cost-sharing starting January 1, 2015, by nongrandfathered commercial plans. Medicare is considering coverage for lung cancer screening.
Cost-Effectiveness and the Medicare Budget
Development of a Medicare Beneficiary Comprehension Test: Assessing Medicare Part D Beneficiaries’ Comprehension of Their Benefits
Medicare Part D, the senior prescription drug benefit plan, was introduced through the Medicare Modernization Act of 2003. Medicare beneficiaries receive information about plan options through multiple sources, and it is often assumed by consumer health plans and healthcare providers that beneficiaries can understand and compare plan information.
Understanding the Options: An Essential Ingredient in Our Evolving Healthcare System
Assessing Medicare Beneficiary Eligibility for Medication Therapy Management Programs Using PINNACLE, a National Cardiovascular Data Registry
Sarah A. Spinler, PharmD, Mark J. Cziraky, PharmD, Fengming Tang, MS, Gladys G. Dueñas, PharmD, Tyan Thomas, PharmD, Jennifer A. Reinhold, PharmD, Vincent J. Willey, PharmD
Medication therapy management (MTM) is a mandated component of the 2003 Medicare Modernization Act for Part D prescription drug plans and Medicare Advantage plans, authorizing the pharmacist or other qualified provider to identify, resolve, and prevent medication-related problems for patients with chronic diseases. MTM programs have been shown to improve medication adherence and reduce medication errors while reducing overall costs in patients with cardiovascular (CV) disease; however, MTM has been greatly underutilized for patients with chronic diseases.
Hanging Together for Patient-Centered Medical Care
Christopher Hvisdas, PharmD Candidate, Andrea Lordan, PharmD Candidate, Laura T. Pizzi, PharmD, MPH, RPh, Brandi N. Thoma, PharmD
In recent years, drug shortages have become a common occurrence in hospital and retail settings, with a record high of 267 drug shortages reported in 2011.1 Julie A.
Drug Shortages in the United States Continue to Undermine Patient Care
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