Journal article
Medicare's Variation in Out-of-Pocket Costs for Prescriptions: The Irrational Examples of In-Hospital Observation and Home Infusion
Journal of the American Geriatrics Society (JAGS), Vol.66(12), pp.2249-2253
12/01/2018
DOI: 10.1111/jgs.15576
PMID: 30264858
Abstract
The Medicare program pays for prescription drugs using several differentand often complicatedmethods. As hospital-based treatment continues to shift from inpatient care to outpatient observation status, and as intravenous infusions continue to shift from hospitals and provider offices into the home, understanding Medicare's prescription drug benefits is increasingly confusing to providers and beneficiaries. Not only is it sometimes difficult to determine whether coverage is provided under Medicare Part A, Part B, or Part D, but this determination also has consequences for Medicare beneficiaries' out-of-pocket spending, which may be higher in certain situations. Although Medicare may be a single payer, the system of payment varies depending on where beneficiaries receive treatment; what their income and assets are; whether they are receiving inpatient, outpatient, or hospice services; and whether they are enrolled in original Medicare or a Medicare Advantage managed care plan. Policies are needed to address these anomalies in the design of Medicare prescription drug benefits and reduce the unjustified variation in out-of-pocket costs. J Am Geriatr Soc 66:2249-2253, 2018.
Details
- Title: Subtitle
- Medicare's Variation in Out-of-Pocket Costs for Prescriptions: The Irrational Examples of In-Hospital Observation and Home Infusion
- Creators
- Brad Wright - Iowa Policy ProjectStacie B. Dusetzina - Vanderbilt UniversityGina Upchurch - Senior PharmAssist Durham North Carolina
- Resource Type
- Journal article
- Publication Details
- Journal of the American Geriatrics Society (JAGS), Vol.66(12), pp.2249-2253
- Publisher
- Wiley
- DOI
- 10.1111/jgs.15576
- PMID
- 30264858
- ISSN
- 0002-8614
- eISSN
- 1532-5415
- Number of pages
- 5
- Language
- English
- Date published
- 12/01/2018
- Academic Unit
- Public Policy Center (Archive)
- Record Identifier
- 9984364392802771
Metrics
2 Record Views