Market Strategies International (MSI), a full-service custom and syndicated research and strategic consulting firm, announced key findings from its latest tracking study of Medicare beneficiaries. MSI's study, which focused only on those beneficiaries who already hit the coverage gap or anticipate reaching the gap this year, found that those who have reached the gap reported spending much more on out-of-pocket costs than what those who anticipate hitting the gap expect to spend. Beneficiaries who anticipate hitting the gap underestimate the impact it will have on their out-of-pocket costs. Actual prescription costs are roughly 1.5 times higher among those who have reached the coverage gap compared to estimates among those who expect to reach the gap.
As a result, it's not surprising that beneficiaries have modified their regimens when hitting the gap. "Unfortunately," stated Jack Fyock, Ph.D., Head of MSI's Medicare Strategy Division, "a substantial number of these modifications include behaviors that may put their health at risk. Noncompliant behaviors could lead to more adverse events for those skipping doses or not filling prescriptions." "Additionally," noted Fyock, "these health risk behaviors could dramatically impact the overall healthcare cost to Medicare."
The good news is that Part D is clearly filling one of the intended objectives of providing most beneficiaries with the opportunity to meet their prescription needs. One in seven beneficiaries, regardless of whether or not they have reached the coverage gap, is filling more prescriptions under Medicare Part D. Beneficiaries taking more than five medications are more likely to report filling a greater number of prescriptions now than prior to enrollment in a Part D plan and, not surprisingly, believe they are spending a lot more now than prior to Medicare Part D. Most beneficiaries are not encountering any problems in getting their prescriptions filled, and those who do, are still able to get their prescriptions filled.
Overall, beneficiaries were moderately satisfied with their current prescription drug plans. Beneficiaries' satisfaction scores on all five measures are similar to those of beneficiaries who had encountered the gap in MSI's 2006 study. Those who anticipate reaching the gap in 2007 have similar satisfaction scores to those who reached the gap in 2006. "Not surprisingly, said Fyock, "those in better health, with higher incomes, and taking fewer medications have higher levels of satisfaction. Higher satisfaction among Medicare Advantage PD beneficiaries may reflect the 'one-stop' nature of their Medicare coverage."
For those beneficiaries who hit the coverage gap in 2006, twenty percent of them actually switched plans for 2007, while over fifty percent considered switching. Most of those who switched plans did so because of their prior plan's high cost or its formulary coverage. "Roughly ten percent of all beneficiaries consider other healthcare coverage each year," according to Ellen Gordon, Ph.D. and Research Director for this study, "therefore, the fifty percent figure may reflect more unease, greater uncertainty or increased dissatisfaction with their Part D plans." Gordon noted, " Those enrolled in stand-alone PDPs, who took more prescriptions, or had higher levels of education were more likely to compare companies and, not surprisingly, these groups were more likely to indicate that they had switched plans in 2007."
