This Kaiser Family Foundation (KFF) brief, updated November 2009, and compiled in conjunction with researchers at Georgetown University and the National Opinion Research Center at the University of Chicago, examines the Medicare Prescription Drug Benefit Program (Part D) stand alone plans available in 2010.  The brief examines plans based on region, premiums, and benefit design and offers an analysis of key plan changes since 2006.

Full brief: http://www.kff.org/medicare/upload/7986.pdf 

Kaiser Family Foundation. (2009). Part D plan availability in 2010 and key changes since 2006. Jack Hoadley, Juliette Cubanski, Elizabeth Hargrave, Laura Summer, and Tricia Neuman.

This study uses data from August 2006 to July 2007 to determine the distribution of psychotropic drug prescriptions by medical specialty.  The authors find that 59 percent of psychotropic prescriptions were written by general practitioners, 23 percent by psychiatrists and 19 percent by other physicians. 

Mark, T. L., Levit, K. R., Buck, J. A. (2009). Psychotropic Drug Prescriptions by Medical Specialty. Psychiatric Services, 60, 1167. DOI: 10.1176/appi.ps.60.9.1167 http://psychservices.psychiatryonline.org/cgi/pdf_extract/60/9/1167 

Authors: Tami L. Mark, Katharine R. Levit, Jeffrey A. Buck.

This article discusses the implications of the Sequenced Treatment Alternatives to Relieve Depression (STAR*D) trial for private and public payers.  The STAR*D trial found that, for second- and third-line treatment, no second-generation antidepressant was superior to another in terms of effectiveness or of the overall incidence of harmful effects.  The authors conclude that the findings have allowed payers to construct coverage rules with greater confidence.

Little, A., Hansen, R. A., Gartlehner, G. (2009). Impact of the STAR*D trial from the perspective of the payer. Psychiatric Services, 60, 1463-1465. DOI: 10.1176/appi.ps.60.11.1463 http://ps.psychiatryonline.org/cgi/content/abstract/60/11/1463 

Authors: Alison Little, Richard A. Hansen, Gerald Gartlehner, Carrie Gray. 

This study published in Health Affairs examines Medicare Prescription Drug Benefit Program (Part D) selection in 2006, finding that enrollees in stand-alone prescription drug plans had higher baseline costs and poorer health than enrollees Medicare Advantage (MA) prescription plans.  The authors speculate that such patterns could adversely affect Medicare costs in the future. 

Riley, G. F., Levy, J.M., Montgomery, M. A. (2009). Adverse selection in the Medicare prescription drug program. Health Affairs, 28(6), 1826-1837. DOI: 10.1377/hlthaff.28.6.1826 http://content.healthaffairs.org/cgi/content/abstract/28/6/1826 

Authors: Gerald F. Riley, Jesse M. Levy, Melissa A. Montgomery.

This Center for Health Care Strategies Inc. (CHSC) report, funded by Kaiser Permanente, used pharmacy claims to supplement a 2007 report in order to better analyze Medicaid’s high-cost and high-need populations.  The addition of pharmacy data revealed that the proportion of disabled beneficiaries diagnosed with three or more chronic conditions is 45 percent rather than 35 percent, as was previously estimated, and that the frequency of psychiatric illness among disabled beneficiaries is 49 percent rather than 29 percent. 

From the introduction:

This third edition of the Faces of Medicaid (Faces of Medicaid III) was commissioned by CHCS to provide a more comprehensive view of beneficiaries with multiple chronic conditions, particularly those with serious mental illness. It builds on the earlier Faces of Medicaid II analysis published in 2007, which sought to answer two key questions: (1) what is the prevalence of chronic conditions within the Medicaid population; and (2) are there patterns or clusterings of these conditions that could inform the development of more appropriate guidelines, care models, performance measurement systems, and reimbursement methodologies.   This new edition examines two powerful new data sources — one year of pharmacy claims and five years of diagnostic data — to further refine the portrait of Medicaid beneficiaries. 

Center for Health Care Strategies, Inc. (2009). The faces of Medicaid III: refining the portrait of people with multiple chronic conditions. Kronick, R., Bella, M., &  Gilmer, T.P.

Full report: http://www.chcs.org/usr_doc/Faces_of_Medicaid_III.pdf 

This Kaiser Family Foundation report analyzes the 2010 Medicare drug plan information released by the Centers for Medicare & Medicaid Services on Oct. 1, 2009.

From the Report:

The average monthly PDP premium in 2010 (weighted by 2009 enrollment, assuming beneficiaries remain in their current plan) will be $38.85.4 This is an 11 percent increase from the weighted average monthly premium of $35.09 in 2009, and a 50 percent increase from $25.93 in 2006, the first year of the Medicare Part D drug benefit.

• Average monthly premiums (weighted by enrollment) have risen every year since 2006 for PDPs.
• The increase in monthly Part D premiums in 2010 is likely to result in reductions in monthly Social Security payments for many Part D enrollees, because no Social Security cost-of-living increase is projected in 2010.
• About 1.2 million beneficiaries enrolled in PDPs will experience an increase of at least $10 in their monthly plan premium unless they select a less expensive plan.

Kaiser Family Foundation. (2009). Medicare Part D Spotlight: Part D Plan Availability in 2010 and Key Changes Since 2006. Jack Hoadley, Juliette Cubanski, Elizabeth Hargrave, Laura Summer, and Tricia Neuman.

Full report: http://www.kff.org/medicare/upload/7986.pdf