Elliott Marc N, Landon Bruce E, Zaslavsky Alan M, Edwards Carol, Orr Nathan, Beckett Megan K, Mallett Joshua, Cleary Paul D
Marc N. Elliott (
Bruce E. Landon is a professor of health care policy and medicine in the Department of Health Care Policy at Harvard Medical School and the Division of General Medicine and Primary Care at Beth Israel Deaconess Medical Center, both in Boston, Massachusetts.
Health Aff (Millwood). 2016 Mar;35(3):456-63. doi: 10.1377/hlthaff.2015.0816.
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.
自2006年以来,医疗保险受益人能够通过独立的处方药计划或其医疗保险优势(MA)健康计划获得处方药保险,2015年72%的受益人选择了这些选项。利用2007年至2014年对700个计划中64岁以上社区居住医疗保险受益人的数据,我们比较了受益人对独立计划提供或纳入MA计划的医疗保险处方药保险的评估。独立计划中的受益人一直报告说,与MA计划中的受益人相比,他们在处方药计划(获取药物的便利性、获取保险信息和获取成本信息)方面的体验不太积极。由于MA计划负责总体医疗保健成本,它们可能比独立处方药计划拥有更综合的系统和更大的激励措施,以便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。