The Centers for Medicare and Medicaid Services has announced access to preferred cost-sharing pharmacies has improved, with the bottom 10 percent of plans so far this year offering access within two miles of 71 percent of urban beneficiaries. That's compared to 40 percent of beneficiaries who had similar geographic access in 2014.
CMS claims the improvement is largely due to actions taken last year, when it was reported that many beneficiaries lacked ready access to preferred cost-sharing pharmacies. The issue, it said, is that Part D plans are increasingly creating smaller networks of pharmacies within the larger networks, and offering lower cost-sharing arrangements to those who use the preferred pharmacies. The cost-sharing arrangements are appealing to those hoping to save money on their prescription drugs, but in some cases, the pharmacies were located too far away from beneficiaries to be of any real benefit.
[Also: Study: Better cost-sharing helps seniors cut down on doctor visits]
In an analysis released last year, CMS looked at the availability of these pharmacies to Part D enrollees, and learned that the news wasn't all bad: Most lived in areas where Part D plans provide solid preferred cost-sharing pharmacy networks. But in all areas, there were at least some people who had limited or no access, especially in urban locales.
To address the issue, CMS announced last year that it would work with outlier plans to tackle concerns about access and marketing. It also required plans whose preferred cost-sharing networks are outliers to disclose in their marketing materials that their plan offered less access.
Additionally, CMS published access levels for each plan offering a preferred cost-sharing benefit structure.
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