Study: Insurers Raising Medicare Rx Drug Rates Due to Low Repayment
Health insurers, seeking to avoid low reimbursements for providing prescription drug benefits to low-income Medicare beneficiaries, have increased premiums for their Medicare Part D prescription drug benefit plans to ensure they are too costly for such beneficiaries, according to a study to be published in the December issue of Health Affairs, United Press International reports.
According to study lead author John Hsu, of the Mongan Institute for Health Policy at Massachusetts General Hospital, Medicare's Part D program originally was intended to encourage competition and subsidize the cost of drugs for low-income Medicare beneficiaries.
However, the study found that reimbursements to insurers who cover low-income Medicare beneficiaries are lower than the total costs incurred by insurers, which creates a disincentive for companies to participate in the program.
Hsu said, "Instead, the system induces companies to play 'hot potato' with the poorest of our elderly," forcing millions of beneficiaries to switch plans.
The study states that Part D payments should be revised by increasing the subsidies for coverage of low-income patients or by improving the risk-adjustment approach (United Press International, 11/1).This is part of the California Healthline Daily Edition, a summary of health policy coverage from major news organizations. Sign up for an email subscription.