BNA’s Health Care Daily Report™ sets the standard for reliable, high-intensity coverage of breaking health care news, covering all major legal, policy, industry, and consumer developments in a...
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.”
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.
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 email@example.com
To contact the editor responsible for this story: Ward Pimley at firstname.lastname@example.org
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.
All Bloomberg BNA treatises are available on standing order, which ensures you will always receive the most current edition of the book or supplement of the title you have ordered from Bloomberg BNA’s book division. As soon as a new supplement or edition is published (usually annually) for a title you’ve previously purchased and requested to be placed on standing order, we’ll ship it to you to review for 30 days without any obligation. During this period, you can either (a) honor the invoice and receive a 5% discount (in addition to any other discounts you may qualify for) off the then-current price of the update, plus shipping and handling or (b) return the book(s), in which case, your invoice will be cancelled upon receipt of the book(s). Call us for a prepaid UPS label for your return. It’s as simple and easy as that. Most importantly, standing orders mean you will never have to worry about the timeliness of the information you’re relying on. And, you may discontinue standing orders at any time by contacting us at 1.800.960.1220 or by sending an email to email@example.com.
Put me on standing order at a 5% discount off list price of all future updates, in addition to any other discounts I may quality for. (Returnable within 30 days.)
Notify me when updates are available (No standing order will be created).
This Bloomberg BNA report is available on standing order, which ensures you will all receive the latest edition. This report is updated annually and we will send you the latest edition once it has been published. By signing up for standing order you will never have to worry about the timeliness of the information you need. And, you may discontinue standing orders at any time by contacting us at 1.800.372.1033, option 5, or by sending us an email to firstname.lastname@example.org.
Put me on standing order
Notify me when new releases are available (no standing order will be created)