Drug Coverage, Utilization, and Spending by Medicare Beneficiaries with Heart Disease

Sharma, Ravi; Hongji Liu, Ravi; Yinghua Wang, Ravi
March 2003
Health Care Financing Review;Spring2003, Vol. 24 Issue 3, p139
Academic Journal
For Medicare beneficiaries who report having heart disease, drug coverage and type of supplemental health insurance affect the likelihood of usage and costs of heart medications, but not the extent of usage. Nearly one in five does not use heart medications and of the latter, one-third lack drug coverage. Some non-users without drug coverage go without prescribed heart medications because of limited financial access. Compared to non-users with coverage, they utilize medical provider services more, and if hospitalized, their inpatient costs are twice as high. Medicare may accrue cost savings by providing drug coverage to and monitoring these at-risk beneficiaries.


Related Articles

  • Skilled Nursing Facilities: Medicare Payment Changes Require Provider Adjustments But Maintain Access: HEHS-00-23.  // GAO Reports;12/14/1999, p1 

    In 1998, Medicare began the transition to a prospective payment system for skilled nursing facility services provided to Medicare beneficiaries. Medicare began paying fixed, preset rates for each day of care?a major change from the former system of cost-based reimbursement. GAO found that the...

  • Capping drug benefits does not reduce total medical costs.  // PharmacoEconomics & Outcomes News;6/17/2006, Issue 505, p4 

    The article discusses research being done on the total medical costs of patients whose drug benefits were capped and those whose benefits were not capped. It references a study by J. Hsu and colleagues in the June 2006 issue of the "New England Journal of Medicine." The researchers used a...

  • IRF "75 Percent Rule" Effective, but Costs Continue to Increase: CMS.  // hfm (Healthcare Financial Management);Jul2007, Vol. 61 Issue 7, p9 

    The article reports on the modification of the memo for Centers for Medicare and Medicaid Services (CMS) in the U.S. The memo was issued on June 8, 2007 and updated the information for the implementation of the 75 percent rule of inpatient rehabilitation facility (IRF) prospective payment system...

  • The impact of Part D on manufacturers. Lipowski, Earlene // Drug Topics;1/8/2007, Vol. 151 Issue 1, p30 

    The article discusses the benefits and impacts of Medicare Part D plan on Medicare beneficiaries and pharmaceutical manufacturers in the U.S. It mentioned that the benefit is seen to increase access to medication among, the government programs runs, risk of concentrating purchase power by...

  • Changes and decision facing beneficiaries. Lipowski, Earlene // Drug Topics;11/6/2006, Vol. 150 Issue 21, p23 

    The article reports on several changes in Medical plans in the U.S. The annual open enrollment for November and December 2006 features a new look to Medicare and sets Part D coverage apart from Parts A and B. The beneficiaries' Part D benefit will continue if he or she takes no action. However,...

  • Delivering Medicare more nimbly.  // KM World;Jan2006, Vol. 15 Issue 1, p6 

    The article presents information on the Medicare and Medicaid services offered by the Noridian Administrative Services (NAS). NAS, a federal contractor for the Centers for Medicare and Medicaid Services (CMS) has set agility, quality and cost containment among their goals. This service provider...

  • Medicare Short-Stay Hospital Utilization Trends: CYs 1972-92.  // Health Care Financing Review;Summer94 Supplement, Vol. 15, p48 

    The article provides information on Medicare short-stay hospital (SSH) utilization trends from 1972 to 1992. The measurement of SSH utilization trends is based on the annual total days of care (TDOC) rate per 1,000 enrollees, which is the product of the annual discharge rate per 1,000 enrollees...

  • Unintended Consequences. MASTERSON, LES // HealthLeaders Magazine;Jul2009, Vol. 12 Issue 7, p58 

    The article examines the consequences of the private Medicare program called Medicare Advantage for health insurance beneficiaries and their families in the U.S. The program is said to have caused an increase in fees by 13 percent. Supporters say that cutting Medicare Advantage payments could...

  • States drive integrated models to improve care for dual eligibles. Bonvissuto, Kimberly // Managed Healthcare Executive;Mar2011, Vol. 21 Issue 3, p6 

    The article focuses on financing and care delivery channels to optimize benefits for 9 million dual eligibles in the U.S. Based on the figures from the Association for Community Affiliated Plans (ACAP), total annual spending on beneficiaries is projected to be more than 775 billion dollars in...


Read the Article

Other Topics