Gorman John
Gorman Health Group, Washington, USA.
Manag Care. 2006 Jul;15(7 Suppl 3):6-9.
The landscape of coverage for prescription drugs for Medicare beneficiaries has dramatically changed as a result of Medicare Part D. As regulations were drafted to govern this program, the federal government's fear was that because pharmacy benefit managers had never gone at risk for the management of medications, plans would be reluctant to enter the new arena of Medicare drug coverage. Of course, that has not happened as hundreds of various plans have entered this market, including a new form of managed care plan referred to as a "special needs plan". The landscape of health care has changed and will continue to change as Medicare Part D changes, both as the result of competitive market forces and regulatory actions.
由于医疗保险D部分的实施，医疗保险受益人的处方药覆盖情况发生了巨大变化。在起草管理该计划的法规时，联邦政府担心，由于药房福利管理人员从未承担过药物管理的风险，各计划将不愿进入医疗保险药品覆盖的新领域。当然，这种情况并未发生，因为数百种不同的计划已进入该市场，包括一种被称为“特殊需求计划”的新型管理式医疗计划。随着医疗保险D部分的变化，医疗保健格局已经并将继续发生变化，这既是竞争市场力量的结果，也是监管行动的结果。
