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Implementation of Medicare Part D and Nondrug Medical Spending for Elderly Adults With Limited Prior Drug Coverage Haiden Huskamp PhD, J. Michael McWilliams MD, Alan Zaslavsky. Jon Wilson Mercer PharmD Candidate C/O 2012. Medicare Part D. Introduced in January 2006 Increased medication use
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Implementation of Medicare Part D and Nondrug Medical Spending for Elderly Adults With Limited Prior Drug CoverageHaiden Huskamp PhD, J. Michael McWilliams MD, Alan Zaslavsky • Jon Wilson • Mercer PharmD Candidate • C/O 2012
Medicare Part D • Introduced in January 2006 • Increased medication use • Reduced out of pocket costs • Adherence to essential medications for elderly persons
Before Part D • Limits on drug benefits for elderly adults were associated with greater use of acute care
Objective • To assess changes in nondrug medical spending following the introduction of Part D for Medicare beneficiaries with limited prior drug coverage. • Study cohort(2004-2007) and control cohort(2002-2005)** **To assess changes in spending when not affected by Part D
Study Cohort • Longitudinal survey data and Medicare claims from 2004-2007. • Data before and after implementation of Part D • 2538 patients with generous drug coverage before 2006 • 3463 patients with limited drug coverage before 2006
Control Cohort • Survey Participants from 2002-2005 • 2537 with generous drug coverage • 3451 with limited drug coverage
Study Population • Inclusion • Enrolled in traditional Medicare at the beginning of 2002/2004 • Exclusion • Patients who became eligible for Medicare before age 65 • Military Veterans who received care from VA Criteria the same for both Study and Control Cohorts
Nondrug Medical Spending • Assessed quarterly • Inpatient and skilled nursing facility institutional services cover by Part A • Physician and ancillary services covered by Part B • Since Part B covers inpatient and outpatient physician services, outpatient data was analyzed to distinguish differences
Results • Nondrug medical spending after Part D was 3.9% lower for participants with limited prior drug coverage than those with generous coverage. • -$306/quarterly between observed and expected
Control Cohort Results • Differences in nondrug medical spending between participants with limited vs. generous drug coverage in 2002 were similar before and after January 1, 2004.
Conclusion • Implementation of Part D was associated with differential reductions in nondrug medical spending for Medicare beneficiaries with limited prior drug coverage.
Comment • Increased medication use and adherence achieved through Part D have been associated with decreased spending for nondrug medical care. • Drug coverage gains may have also reduced early complications of acute conditions.
