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Managed Care March 2006 David Adler	Tiers Reach New Heights Under Part D Can commercial health plans learn from Medicare Advantage Prescription Drug Plans that have four or more formulary levels?
Managed Care December 2007	Insurers Offer More Coverage to Fill Part D Gap Filling the gap in coverage in which the enrollee pays 100% of total drug costs before catastrophic coverage begins will be a significant issue that stand-alone Prescription Drug Plans and Medicare Advantage Prescription Drug plans face in 2008.
Managed Care January 2007	Seventy-Five Percent of Cancer Drugs Covered Under Medicare Part D Seventy-five percent of cancer drugs are covered by Medicare Part D plans, with regional Medicare Advantage prescription drug plans covering 85 percent.
Managed Care December 2006 Martin Sipkoff	Federally Negotiated Drug Prices Anticipated for Medicare Part D Congress to force the issue of federally negotiated drug prices. This could eventually lead to a government-run drug plan.
Managed Care March 2007	Use of Generics On the Rise Recent data indicate that generic medication accounts for nearly 60% of the drugs dispensed to people in Medicare Prescription Drug Plans and Medicare Advantage plans.
Managed Care June 2006 John Carroll	When New Drugs Are Costly, How High to Raise Copays? As some pretty costly, yet very useful, drugs are introduced, will new formulary designs deny access to needy patients?
Registered Rep. October 13, 2011 Mark Miller	Determining Your Elderly Clients' Best-Fit in Medicare Plans You may be able to help senior clients save thousands of dollars in out-of-pocket health care costs by encouraging them to comparison shop for Medicare prescription drug and managed care options during the program's annual fall enrollment season.
Managed Care February 2005	Medicare's Drug Coverage Seeks To Strike Compromise Health plan officials are still trying to determine just how the final rules for the new Medicare prescription drug benefit will affect them, because it appears that government officials tried their best to address the competing concerns of all players.
Managed Care December 2007 Martin Sipkoff	Large Plans Do Well Under Part D, But Premium Hikes Cloud Future Profits should increase over the next two years for plans that stay the course, but politics and rising premiums may affect long-term results.
Managed Care August 2001 Steve Perlstein	Four-Tier Approach Injects Consumerism Into Drug Benefit In tying copayments closely to the actual cost of medications, Humana takes a step toward promoting awareness of resource use...
Managed Care March 2008	PDP Drug Restrictions Block Comparison Shopping A review of 169 commonly used drugs covered by Medicare Prescription Drug Plans (PDPs) reveals that only 4 of the 10 largest plans by enrollment have all of those 169 drugs on formulary.
Managed Care March 2007 Louis W. Hutchison	Unable to Carry Cost Burden, Payers Seek Other Remedies The pharmacy benefit landscape of today is all but unrecognizable from its predecessor of just a decade ago. Blending an approach that uses education, reward, and penalty can rein in runaway health care costs
Managed Care December 2002	Drug-discount program's effectiveness hindered by lack of use California offers a prescription drug discount program that allows Medicare beneficiaries to get discounts just by showing their Medicare cards to pharmacists. Unfortunately, a majority of those eligible -- both those with and without drug coverage -- have never heard of the program.
Managed Care May 2001	Old Ideas About Formulary Structure Gone as Humana Tests 4-Tier Model Humana is phasing in a four-tier formulary that categorizes prescription drugs by costs, rather than generic or brand status. The higher the drug's acquisition cost -- regardless of whether it's a branded or generic product -- the higher the tier it lands in...
Managed Care September 2000	Any way you cut it, employers appear to save if Medicare adopts drug benefit A new analysis suggests that a prescription drug benefit in Medicare would reduce employer expense for health coverage--which, in turn, could encourage more employers to offer some form of drug coverage and thus reverse this erosion...
Pharmaceutical Executive May 1, 2014 Jill Wechsler	Reimbursement Limits Threaten Drug Access High cost-sharing, narrow formularies create problems for pharma companies and patients.
Registered Rep. October 10, 2014 Mark Miller	Healthcare Inflation is on the Mend Tame healthcare inflation is good news for your retired clients.
Managed Care December 2002	M+C meltdown hinders access to medications The fact that health plans are abandoning Medicare+Choice at a slower rate than in previous years doesn't mask the fact that the exodus of plans only exacerbates the problem of lack of pharmaceutical coverage for the elderly.
Managed Care October 2002	Though M+C Erosion Slows, Reimbursement Still an Issue The exodus of health plans from Medicare+Choice will moderate somewhat next year, offering hope that the struggling system can make a comeback.
Managed Care March 2002 Michael Levin-Epstein	Illinois's Medicare Drug Program Called 1st Stab at National Reform The Illinois demonstration program gives the state permission to use federal and state Medicaid dollars to provide prescription drug coverage for 365,000 low-income, elderly Medicare beneficiaries...
Registered Rep. January 2, 2013 Kevin McKinley	Mapping the Medicare Maze Advisors can shed some much-appreciated light on this crucial but confusing program.
Managed Care August 2001	Prescription Plan For Medicare Faces Lawsuit President Bush's plan to give prescription discounts to Medicare beneficiaries has created quite a storm...
Managed Care May 2000	Prescription Drug Benefit Gaining In Election Year Considered a dead issue just weeks ago, a prescription drug benefit in Medicare is suddenly thought to be the health care issue with the best chance for passage this year....
Managed Care July 2002 Thomas Kaye	Managing the Drug Benefit: One Company's Experience The pharmacy director of Blue Cross of Oklahoma shares his company's success with using three tiers and coinsurance to promote member responsibility.
Financial Planning April 1, 2010 Donald Jay Korn	Medicare: Change is Coming This is a great time to get together with clients over 65 who will be affected by health care changes and go over their Medicare coverage. At the same time, you can see what other areas of financial planning are on their mind.
Managed Care May 2006	Headlines On Deadline . . . Health plans appear to be having some trouble fulfilling a federal mandate that 80 percent of questions from Medicare beneficiaries about pharmacy coverage be answered within 30 seconds.
Managed Care April 2005	Medicare Modernization Act to Increase Public Sector Spending Nearly 50 Percent While the burden on the public sector to supply health care benefits to Medicare and Medicaid enrollees will increase, on the private side, a reevaluation of current forms of health insurance coverage may take place as growth in premiums continues to outpace growth in compensation.
Managed Care March 2002	How Medicare beneficiaries spend money on drugs The Kaiser Family Foundation notes that Medicare beneficiaries account for 14 percent of the U.S. population, but for 43 percent of the nation's spending on prescription drugs. Thirteen percent of beneficiaries had to pay $2,000 or more out of pocket in 2001...
Managed Care August 2004 Martin Sipkoff	Bad Tiered Formulary Designs Yield Poor Outcomes, High Cost Now that tiered formularies rule the land, what many suspected is being demonstrated: Compliance is suffering and so, too, are patients.
Managed Care September 2006 John Carroll	Managed Medicare Revitalized: Feel-Good Plan of the Decade Insurers are largely happy with what they've seen. They're creating new benefit packages and expect more business in the next one to three years.
Knowledge@Wharton July 30, 2003	Restructuring Medicare Is a Riskier Operation than First Thought Hailed as a bipartisan success when passed in late June, two Medicare reform bills are losing some of their luster as they face closer scrutiny by a conference committee made up of members of both chambers charged with reconciling the legislation this fall.
Managed Care November 2005 Martin Sipkoff	Confusion Rules the Day As Medicare Part D Begins With a dizzying array of coverage possibilities, there is a strong possibility that some people who would benefit will fail to enroll in any plan.
Registered Rep. November 1, 2005 Lynn O'Shaughnessy	Medicare Drug Benefit 101 If financial advisers can understand the basics of the new Medicare drug benefit plan, they can provide a great service to their clients -- perhaps even save them money in premiums. Here's where to start.
Pharmaceutical Executive November 1, 2005 Jill Wechsler	Washington Report: Out of Commission? Crawford Steps Down The clouded circumstances of the commissioner of the Food and Drug Administration may complicate the process of securing a permanent leader. Meanwhile, battles continue over hot-button issues such as the morning-after pill and the regulation of follow-on biologics.
Managed Care August 2006	So Far, Experts Like What They See in Part D Health care opinion leaders so far think Medicare Part D is a success, though changes are needed to the program, according to a survey by the Commonwealth Fund.
Managed Care May 2002	Drug Companies Unveil Their Plan For Discount Card In the absence of any congressional action on a pharmacy benefit in Medicare, seven pharmaceutical companies have teamed up to offer a drug discount card that many call a vital first step in shoring up Medicare coverage
Managed Care September 2004	Bush Officials Seek Bounce From Medicare Reform Law Unfortunately for Bush, a recent survey says that most Medicare recipients who plan to let this issue influence their vote plan to cast those votes for Sen. John Kerry.
Managed Care January 2002	Employers struggle to preserve pharmacy benefit In an effort to protect the pharmacy benefit for employees, companies are using a variety of techniques to manage expenditures...
Financial Advisor March 2006 Karen DeMasters	Clients Lost In Medicare Lurch Although some of the more than 40 million eligible Medicare recipients in the nation already have signed up for the new prescription drug benefits program Part D, many people still are seeking the advice of financial planners and weighing the options that are available to them.
Knowledge@Wharton	Prescription Drug Coverage for Seniors Faces Uncertain Future The discussion about adding a prescription drug benefit to Medicare will be put on hold...
Managed Care November 2007	Patient Advocates Want Part D Changes A Medicare-administered drug benefit would be more affordable and comprehensive than the current private insurance-run drug benefit, say patient advocate groups.
Searcher October 2011 Stephanie C. Ardito	The Medical Digital: Navigating the Medicare Maze Since entitlement programs are the chief governmental programs under fire, I decided to revisit the healthcare bills passed back in March (H.R. 3590, the Patient Protection & Affordable Care Act).
Financial Planning April 1, 2011 Donald Jay Korn	Front and Center With baby boomer clients entering the age of Medicare, it will become increasingly important for planners to keep up with the inevitable new wrinkles.
Managed Care July 2000 Michael Levin-Epstein	Congress Asked To Take Action As HMOs Flee Managed Medicare Thanks mainly to the increasing cost of providing a prescription drug benefit, HMOs are exiting Medicare+Choice, the system that was supposed to manage the health of the nation's senior citizens, in droves. Only an act of Congress can save Medicare+Choice, but is seems doubtful that will happen.
Pharmaceutical Executive May 1, 2006 Huang, Pesile & Mozeson	Medicare Part D: D for Doomed? New drug coverage plans cost more money and serve fewer patients than the government expected. What if things get worse? Here are two scenarios for disaster.
Managed Care May 2001 Michael Levin-Epstein	Prescription Drug Talk Cooled Off Faster Than a Texas Thunderstorm Medicare reform -- and especially prescription drug benefits within Medicare -- no longer appears to be the burning issue it once was on Capitol Hill. The culprits: priorities and money...
Pharmaceutical Executive October 1, 2008 Jill Wechsler	Part D Under Attack Congressional leaders ready campaign to curb Medicare drug plans.
Financial Planning February 1, 2006 Janet Aschkenasy	Drug Deals Here is how to help your financial advisory clients make sense of Medicare Part D.
Managed Care June 2002	Calif. Blues Plan Says No Tiers For Hospitals Blue Cross of California has abandoned its plan to separate hospitals by copayment tiers.
CFO June 1, 2005 Russ Banham	Prescription for Malaise? Health-insurance providers are rushing to participate in Medicare's new drug-benefit program. Companies are proceeding with caution.