Adverse selection in the medicare prescription drug program

Health Affairs

Volumn 28, Issue 6, 2009, Pages 1826-1837

  Riley, Gerald F ^a   Levy, Jesse M ^a   Montgomery, Melissa A ^a  

^a CENTERS FOR MEDICARE AND MEDICAID SERVICES   (United States)

Author keywords

[No Author keywords available]

Indexed keywords

CONFERENCE PAPER; CONTROLLED STUDY; DRUG PROGRAM; HEALTH CARE COST; HEALTH CARE POLICY; HEALTH SURVEY; HUMAN; MEDICARE; PRESCRIPTION; RISK FACTOR;

COSTS AND COST ANALYSIS; DRUG COSTS; DRUG PRESCRIPTIONS; HUMANS; INSURANCE COVERAGE; MEDICARE PART D; STATE HEALTH PLANS; UNITED STATES;

EID: 77952185262     PISSN: 02782715     EISSN: 15445208     Source Type: Journal    
DOI: 10.1377/hlthaff.28.6.1826     Document Type: Conference Paper

References (20)

1. Huh S, Rice T, Ettner SL. Prescription drug coverage and effects on drug expenditures among elderly Medicare beneficiaries. Health Serv Res. 2008;43(3):810-32.
2. Congressional Budget Office. Issues in designing a prescription drug benefit for Medicare. Washington (DC): CBO; 2002 Oct.
3. Centers for Medicare and Medicaid Services [Internet]. Baltimore (MD): CMS; c2008. Press release, Medicare prescription drug benefit's projected costs continue to drop. 2008 Jan 31 [cited 2009 Sep 10]; [about 2 screens]. Available from http://www.cms.hhs.gov/apps/media/press/release.asp?Counter=2868
4. Hoadley J, Hargrave E, Merrell K, Cubanski J, Neuman T. Benefit design and formularies of Medicare drug plans: a comparison of 2006 and 2007 offerings [Internet]. Menlo Park (CA): Henry J. Kaiser Family Foundation; 2006 Nov [cited 2009 Sep 10]. Available from: http://www.kff.org/medicare/upload/7589.pdf
5. Wrobel MV, Doshi J, Stuart BC, Briesacher B. Predictability of prescription drug expenditures for Medicare beneficiaries. Health Care Financ Rev. 2003;25(2):37-46.
6. Robst J, Levy JM, Ingber MJ. Diagnosis-based risk adjustment for Medicare prescription drug plan payments. Health Care Financ Rev. 2007;28(4):15-30.
7. Adler G. A profile of the Medicare Current Beneficiary Survey. Health Care Financ Rev. 1994;15(4):153-63.
8. Eppig FJ, Chulis GS. Matching MCBS and Medicare data: the best of both worlds. Health Care Financ Rev. 1997;18(3):211-29.
9. Poisal JA. Reporting of drug expenditures in the MCBS. Health Care Financ Rev. 2003;25(2):23-36.
10. Data on these four sources of coverage were captured at single points in time: fall 2006 for FEHB and VHA, and June 2007 for Tricare and active workers.
11. Pope GC, Kautter J, Ellis RP, Ash AS, Ayanian JZ, Iezzoni LI, et al. Risk adjustment of Medicare capitation payments using the CMS-HCC model. Health Care Financ Rev. 2004;25(4):119-41.
12. For Part D we used a risk score that predicts total drug spending, rather than plan liability, as a measure of health status.
13. Shea DG, Terza JV, Stuart BC, Briesacher B. Estimating the effects of prescription drug coverage for Medicare beneficiaries. Health Serv Res. 2007;42(3 Pt I):933-49.
14. We could not identify generic drug use from our data.
15. Congressional Budget Office. A detailed description of CBO's cost estimate for the Medicare prescription drug benefit [Internet]. Washington (DC): CBO; 2004 Jul [cited 2009 Sep 10]. Available from http://www.cbo.gov/doc.cfm? index=5668&type=0
16. Yin W, Basu A, Zhang JX, Rabbani A, Meltzer DO, Alexander GC. The effect of the Medicare Part D prescription benefit on drug utilization and expenditures. Ann Intern Med. 2008;148(3):169-77.
17. Neuman P, Strollo MK, Guterman S, Rogers WH, Li A, Rodday AM, et al. Medicare prescription drug benefit progress report: findings from a 2006 national survey of seniors. Health Aff (Millwood). 2007;26 (5):w630-43.
18. Heiss F, McFadden D, Winter J. Who failed to enroll in Medicare Part D, and why? Early results. Health Aff (Millwood). 2006;25:w344-54.
19. Riley G, Zarabozo C. Trends in the health status of Medicare risk contract enrollees. Health Care Financ Rev. 2006;28(2):81-95.
20. Pope GC, Greenwald L, Kautter J, Dulisse B, West N (RTI International, Waltham, MA). Final report. Medicare Advantage plan availability, premiums and benefits, and beneficiary enrollment in 2006 [Internet]. Baltimore (MD): Centers for Medicare and Medicaid Services; 2007 Nov [cited 2009 Sep 10]. Contract no. 500-00-0024, task order 17. Available from http://www.almedth.org/ BriefingMaterials/RTIMedicareadvantageplan-1449.pdf