Event Title

Addressing the Cost Crevasse: The Need for Medicare Part D Plan Optimization for Beneficiaries with Intellectual and Developmental Disabilities

Document Type

Event

Start Date

29-9-2020 4:00 PM

End Date

29-9-2020 4:00 PM

Description

Title: Addressing the Cost Crevasse: The Need for Medicare Part D Plan Optimization for Beneficiaries with Intellectual and Developmental Disabilities

Background: According to the American Association on Intellectual and Developmental Disabilities, individuals with intellectual and developmental disabilities (IDD) have “significant limitations in both intellectual function and adaptive behavior”. In 2016, individuals with disabilities under the age of 65 accounted for 9.1 million Medicare beneficiaries (16% of the Medicare population). Of those, nearly 2/3 had a cognitive or mental impairment and were likely to receive four times as many prescription drugs as their non-disabled counterparts. Younger Medicare beneficiaries with disabilities have significantly greater cost-related issues in obtaining medications.

Methods: In 2019, University of the Pacific School of Pharmacy (UOP) partnered with an agency that provides services to individuals with developmental disabilities. UOP sought to help lower out-of-pocket prescription drug costs for the agency’s dual-eligible Medicare clients. Trained student pharmacists performed Medicare Part D plan optimization services.

Results: In total, 958 dual-eligible clients with IDD received Part D plan optimization services; 765 (79.9%) were(26.4%) clients, resulting in an estimated aggregate cost savings of $1,636,288 by plan switching. In 79.5% of the cases, cost savings were attributable to formulary coverage of a beneficiary’s medication under the new plan.

Conclusion: Beneficiaries with IDD often require careful evaluation due to higher rates of health-related problems and their relatively low incomes. Trained student pharmacists are positioned to provide Part D plan optimization services, and can enable scarce resources that are earmarked for out-of-pocket prescription costs to be reallocated to other necessary services for this vulnerable population.

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Sep 29th, 4:00 PM Sep 29th, 4:00 PM

Addressing the Cost Crevasse: The Need for Medicare Part D Plan Optimization for Beneficiaries with Intellectual and Developmental Disabilities

Title: Addressing the Cost Crevasse: The Need for Medicare Part D Plan Optimization for Beneficiaries with Intellectual and Developmental Disabilities

Background: According to the American Association on Intellectual and Developmental Disabilities, individuals with intellectual and developmental disabilities (IDD) have “significant limitations in both intellectual function and adaptive behavior”. In 2016, individuals with disabilities under the age of 65 accounted for 9.1 million Medicare beneficiaries (16% of the Medicare population). Of those, nearly 2/3 had a cognitive or mental impairment and were likely to receive four times as many prescription drugs as their non-disabled counterparts. Younger Medicare beneficiaries with disabilities have significantly greater cost-related issues in obtaining medications.

Methods: In 2019, University of the Pacific School of Pharmacy (UOP) partnered with an agency that provides services to individuals with developmental disabilities. UOP sought to help lower out-of-pocket prescription drug costs for the agency’s dual-eligible Medicare clients. Trained student pharmacists performed Medicare Part D plan optimization services.

Results: In total, 958 dual-eligible clients with IDD received Part D plan optimization services; 765 (79.9%) were(26.4%) clients, resulting in an estimated aggregate cost savings of $1,636,288 by plan switching. In 79.5% of the cases, cost savings were attributable to formulary coverage of a beneficiary’s medication under the new plan.

Conclusion: Beneficiaries with IDD often require careful evaluation due to higher rates of health-related problems and their relatively low incomes. Trained student pharmacists are positioned to provide Part D plan optimization services, and can enable scarce resources that are earmarked for out-of-pocket prescription costs to be reallocated to other necessary services for this vulnerable population.