Analysis Finds Number of 2015 Plans Lowest Since Start of Part D Drug Benefit

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By Mindy Yochelson

Sept. 22 — The number of Medicare prescription drug plans will fall by 14 percent in 2015, the smallest number of such plans available since Part D started in 2006, analysts said.

The number of prescription drug plans will drop from 1,169 in 2014 to 1,001 in 2015. There were 1,429 plans in 2006, the first year of the benefit, according to the Henry J. Kaiser Family Foundation. This peaked the following year to 1,875 and has mostly gone down since then.

The Kaiser foundation, a nonprofit focusing on health issues, said in a drug benefit fact sheet Sept. 19 that despite the reduction in availability, “beneficiaries in each state will have a choice of at least two dozen stand-alone PDPs” and multiple Medicare Advantage plans that offer the drug benefit.

The analysts are responding to the Centers for Medicare & Medicaid Services's Sept. 18 release of Medicare “landscape source files” that have data on plan participation, premiums and benefit designs.

Since shortly after the start of the drug benefit, the agency has urged sponsors of plans with low enrollment to reduce their offerings. The CMS has said that limitations in offerings are needed because it has been difficult for beneficiaries to distinguish among plan offerings of the same sponsor when cost sharing and premiums were similar.

Avalere Health, a consulting company, said Sept. 22 that the reduction in plan offerings is “largely driven by a consolidation of offerings by a number of top plan sponsors, including Aetna, Cigna, CVS, and UnitedHealth.”

Avalere said that “these consolidations are expected to shift a large number of beneficiaries into lower-cost plans, driving down average premiums in the market by 2 percent.”

Premium Variation

The Kaiser foundation and Avalere found significant premium variation among plans.

Avalere said that among the 10 prescription drug plans with the highest enrollment, the average monthly premium will range from $15.67 for the Humana Walmart Rx Plan to $52.81 for Humana Enhanced.

Of these top 10, the change in premium from 2014 also varies significantly. Between 2014 and 2015, WellCare Classic's average premium will increase by 52 percent, while Aetna Medicare Rx Saver will drop by 31 percent, Avalere said.

According to the Kaiser foundation, premiums in 2015 will vary across the 34 prescription drug plan regions, ranging from $12.60 to $171.90.

Cost Sharing

Avalere's analysis finds that Part D sponsors may be shifting more cost-sharing responsibilities to beneficiaries.

In 2015, the proportion of prescription drug plans with no deductibles will drop to 42 percent, from 47 percent in 2014, Avalere said.

The Kaiser foundation found that in 2015, the percentage of plans offering a zero-dollar premium will drop by 24 percent. Low-income beneficiaries are assigned to a prescription drug plan that bids at or below the low-income subsidy threshold and can provide zero-dollar premium benefits.

In 2015, 283 plans will be available for enrollment of low-income subsidy recipients, the lowest number of such plans since the program's start in 2006, the Kaiser foundation said.

To contact the reporter on this story: Mindy Yochelson in Washington at myochelson@bna.com

To contact the editor responsible for this story: Ward Pimley at wpimley@bna.com

The KFF fact sheet is at http://kff.org/medicare/fact-sheet/the-medicare-prescription-drug-benefit-fact-sheet. The Avalere information is at http://avalere.com/expertise/managed-care/insights/avalere-analysis-reveals-significant-consolidation-among-pdps.