Gaps in Medicare Part D Self-Enrollment & Nursing Home Residents

描述(由申请人提供)：可靠和负担得起的处方药覆盖范围对疗养院居民来说很重要，他们需要许多药物来管理多种共病情况。然而，由于复杂的登记要求，Medicare Part D(“Part D”)药物计划很难加入。养老院居民有严重的认知、功能和感觉缺陷，这使得D部分的注册特别具有挑战性。这项研究的目的是描述疗养院环境中药物覆盖的现状，确定影响D部分登记的因素，并估计药物覆盖如何影响药物的使用。这项研究的一个独特方面是跟踪一组因医疗补助计划规则而自动加入D部分的居民，并比较他们用药变化前后的情况。我们还将审查重要健康结果的变化，如可避免的住院和死亡。为了完成这些目标，本研究项目将分析从一家大型长期护理药房、养老院住院护理计划、医疗保险计划和养老院调查中收集的数据。此外，该项目将进行一个基于互联网的共识专家小组，以开发一种新的药物使用不足的工具。该项目应处于独特的地位，向联邦医疗保险计划和政策制定者通报疗养院居民在当前D部分登记要求下的经验，以及如何更公平地获得联邦医疗保险计划的这一重要好处。

DESCRIPTION (provided by applicant): Reliable and affordable prescription drug coverage is important to nursing home residents who require many medications to manage multiple co-morbid conditions. Yet, the Medicare Part D ("Part D") drug program is difficult to join due complex enrollment requirements. Nursing home residents have significant cognitive, functional, and sensory deficits that make Part D enrollment especially challenging. The objectives of this study are to describe the current landscape of drug coverage in the nursing home setting, identify factors that influence Part D enrollment, and estimate how drug coverage influences the use of medications. A unique aspect of this study is to follow a group of residents who are automatically enrolled into Part D due to Medicaid program rules, and to compare before and after changes in their medication use. We will also examine changes in important health outcomes such as hospitalizations that are avoidable and death. To complete these objectives, this research project will analyze data collected from a large long-term care pharmacy, nursing home resident care plans, the Medicare program and nursing home surveys. Additionally, this project will conduct an internet-based consensus panel of experts to develop a new tool of medication underuse. This project should be in a unique position to inform the Medicare program and policymakers about the experience of nursing home residents under the current Part D enrollment requirements and how to create more equitable access to this vital benefit of the Medicare program.