WASHINGTON - The Centers for Medicare & Medicaid Services reports that most of the 40 million seniors enrolled in the Medicare Part D prescription drug program are happy with it. However, some experts say the program, now going into its third year, is still plagued with access issues and too much complexity for seniors to manage.
The experts were part of a recent panel briefing hosted by the Alliance for Health Reform and the Commonwealth Fund.
At the briefing, Laura Summer, senior research scholar at Georgetown University's Health Policy Institute, reported on a study of more than 600 Medicare counselors who work with beneficiaries nationwide on a daily basis.
The study, conducted by Georgetown University, the National Senior Citizen's Law Center and the Center for Medicare Advocacy, found that more vulnerable populations struggled with some of the complexities of the program, including understanding what drugs are covered and how to switch from one plan to another. These included low income beneficiaries and those with language, literacy or cognitive barriers, and people with chronic or disabling conditions, Summer said.
More than 40 percent of respondents to the Georgetown study said their Medicare clientsí prescriptions weren't covered under their plan or they had limited access to the drugs, Summer reported.
"Our respondents told us it's not uncommon for beneficiaries to delay getting drugs, to not take their prescriptions for a period of time, and they also told us that the health or well-being of their clients had been affected," Summer said.
In another study OF 16,000 non-institutionalized Medicare beneficiaries conducted by mail in 2006, 33 percent of respondents did not have drug coverage in 2005, according to Stu Guterman, senior program director for the Program on Medicare's Future at the Commonwealth Fund.
The study, conducted by the Kaiser Family Foundation, the Commonwealth Fund and Tufts-New England Medical Center, found that rural beneficiaries, African-Americans and non-white Hispanics reported less coverage in 2006, despite federal incentives to cover low-income and vulnerable populations, Guterman said.
Senior citizens in Part D plans fared better then those who lacked drug coverage in terms of out-of-pocket costs and rates of cost-related non-adherence, the study found. However, so-called "healthier" Medicare beneficiaries without chronic conditions were much more likely to have signed up for Part D than beneficiaries with multiple chronic conditions, the study found.
Tracey McCutcheon, deputy director of the CMS Drug Benefit Group said CMS is working to improve the program and fill the gaps. Beneficiaries face complexities because they are mainly selecting alternative design plan types, not the standard benefit, McCutcheon said.
"One of the things that clearly is working is that this competitive program is holding costs down; premiums are generally stable, and there is a slower growth than predicted in drug costs," McCutcheon said.