Medicare Prescription Drug Plan Enrollees Report Less Positive Experiences Than Their Medicare Advantage Counterparts
Medicare Prescription Drug Plan Enrollees Report Less Positive Experiences Than Their Medicare Advantage Counterparts
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DOI：
10.1377/hlthaff.2015.0816
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发表时间：
2016-03-01
期刊：
影响因子：
9.7
通讯作者：
Cleary, Paul D.
中科院分区：
文献类型：
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作者：
Elliott, Marc N.;Landon, Bruce E.;Cleary, Paul D.
自2006年以来，医疗保险受益人已经能够通过独立的处方药计划或他们的医疗保险优势（MA）健康计划获得处方药覆盖，2015年有72%的受益人行使了选择权。使用2007年至2014年700个计划中64岁以上的社区医疗保险受益人的数据，我们比较了受益人对独立计划或整合到MA计划中提供的医疗保险处方药覆盖率的评估。独立计划的受益人报告的处方药计划的积极体验（获得药物、获得覆盖信息和获得成本信息的便利性）一直低于他们的MA对应者。由于MA计划负责整体医疗保健费用，它们可能比独立的处方药计划有更综合的系统和更大的激励措施，有效地为参保人提供药物和信息，包括自2010年以来，根据《平价医疗法案》的规定，向这些MA计划支付质量奖金。
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.