Safran Dana Gelb, Neuman Patricia, Schoen Cathy, Kitchman Michelle S, Wilson Ira B, Cooper Barbara, Li Angela, Chang Hong, Rogers William H
Health Institute at Tufts-New England Medical Center, Boston, USA.
Health Aff (Millwood). 2005 Jan-Jun;Suppl Web Exclusives:W5-152-W5-166. doi: 10.1377/hlthaff.w5.152.
Beginning in 2006 the Medicare Prescription Drug, Improvement, and Modernization Act (MMA) will offer pharmacy benefits to forty-two million Medicare beneficiaries nationwide. In a 2003 national survey of Medicare beneficiaries age sixty-five and older, more than one-quarter reported no prescription coverage, and nearly half of low-income seniors in some states lacked coverage. Wide coverage differences among states highlight implementation challenges and the need for tailored enrollment strategies. Evidence of Medicaid's highly effective coverage delineates the importance of assuring this group's continued protection under Part D plans. Reports of complex drug regimens, multiple prescribing physicians and pharmacies, nonadherence, and reimportation demonstrate the challenges of integrating seniors' prescription care. We discuss MMA's potential to improve quality and the need to monitor performance.
从2006年开始，《医疗保险处方药、改进与现代化法案》（MMA）将为全国4200万医疗保险受益人提供药房福利。在2003年对65岁及以上医疗保险受益人的全国性调查中，超过四分之一的人表示没有处方药保险，在一些州，近一半的低收入老年人缺乏保险。各州之间广泛的保险差异凸显了实施方面的挑战以及制定针对性参保策略的必要性。医疗补助计划（Medicaid）高效保险的证据表明，确保该群体在D部分计划下持续得到保护非常重要。关于复杂药物治疗方案、多位开处方医生和药房、不依从以及药品再进口的报告表明，整合老年人的处方护理存在挑战。我们讨论了MMA在提高质量方面的潜力以及监测绩效的必要性。
