Medicare Part D

Specialty Drugs Rake in High Out-of-Pocket Costs for Part D Patients

January 31, 2019 - Medicare Part D enrollees with serious illness can expect extraordinary out-of-pocket healthcare costs as they seek drugs for their conditions, according to a recent analysis from the Kaiser Family Foundation (KFF). “The findings come at a time when the public has expressed concern about the rising cost of prescription drugs and policymakers are considering ways to curb such...

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CMS Models Target Patient-Centered Benefits Design, Drug Costs

by Sara Heath

CMS has revealed two new regulations that will ideally improve patient-centered benefits design and lower prescription drug spending, the agency said. Specifically, the agency announced a new Value-Based Insurance Design (VBID) model and...

Medicare Part B Drug Plan Could Raise Out-of-Pocket Patient Costs

by Sara Heath

An HHS proposal to shift some Medicare Part B drugs to Medicare Part D may decrease overall drug spending, but it could increase out-of-pocket patient costs, data suggests. The HHS proposal would shift Part B drugs to Part D prescription...

Part D Drug Price Proposal Could Limit Patient Access to Care

by Sara Heath

Utilization management strategies such as formulary tiers and copayments serve as significant barriers to Medicare Part D drugs for many patients managing serious illness, according to a new report conducted by Avalere Health on behalf of...

CMS Drug Price Proposal Aims to Cut Out-of-Pocket Patient Spending

by Sara Heath

CMS has proposed a new drug price model for Medicare Parts C and D that will ideally reduce out-of-pocket patient spending. The policies, which if approved would go into effect in 2020, would impact Medicare Advantage and Medicare Parts C...

CMS Releases Quality Star Ratings for Medicare Plan Patient Access

by Sara Heath

CMS has released the quality star ratings for Medicare Advantage and Medicare Part D prescription drug plans, according to a public statement. This move comes ahead of the open enrollment session and as a part of the agency’s efforts...

Patients Support Efforts to Cut Out-of-Pocket Drug Costs for Seniors

by Sara Heath

Patients largely support legislative measures that would stabilize the Medicare Part D program, stating that such measures could reduce rising patient financial responsibility and out-of-pocket drug costs, according to a Morning Consult...

Low Medication Adherence Negates Medicare Cost-Sharing Savings

by Sara Heath

Although cost-sharing saves Medicare money on pharmaceutical expenses, these savings are likely negated by low medication adherence and eventual health complications, found a new study published in the American Journal of Managed...

Lower Drug Costs, Subsidy Access Improve Medication Adherence

by Sara Heath

  Improving access to Medicare Part D subsidies and lowering out-of-pocket patient drug costs can help raise medication adherence rates in patients of low socioeconomic status, according to a new study published in the Journal of...


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