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Medicare, Medicaid, Health Reform

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Monthly Archives: May 2005

Winners in the New Medicare Prescription Drug Benefit

The Medicare prescription drug benefit (aka, Medicare Part D) is biggest thing to hit American health care in decades. The massive, costly, and extraordinarily complex new program will likely realign the entire pharmaceutical supply chain and create a raft of new winners and losers in the marketplace. Looking into my crystal ball, here are some likely winners: ● Low-Income Medicare...

Fascinating, Informative Look at the Food and Drug Administration (FDA)

Inside the FDA: The Business and Politics Behind the Drugs We Take and the Food We Eat is a thoughtful, balanced, and well-researched look inside controversial and troubled Food and Drug Administration. Author Fran Hawthorne is an experienced business journalist and her skills are evident here. Digging into the FDA�s complex and conflicting world, the book provides an informative picture...

State Health Care Reform: The Latest Innovations

States continue to serve as laboratories for health care reform. In recent years, many of these state-based efforts have focused on: 1. Leveraging Employer-Based Coverage: With the goal of making health insurance coverage more affordable to small businesses and their employees, state tools include (a) premium assistance, (b) reinsurance to moderate high-risk cases, (c) state negotiated health plan options, and...

Medicare Part D Breeds Savvy New Partnerships

The new Medicare prescription drug benefit requires a new, complex mix of specialized services. The smart players recognize the old rules and strategies no longer apply. They are looking outside their organizations for the skills, infrastructure, and Medicare-specific savvy needed to succeed in Part D. Here

Medicare and Quality of Care: Good News, Bad News

Quality of care in the federal Medicare program remains poor. New evidence shows a wide range of serious, often worsening problems in the physician and hospital care received by America

Risks of Medicare Drug Benefit for Half Million Beneficiaries in Home and Community-Based Programs

The new Medicare prescription drug benefit presents many challenges to the nation's seven million dual Medicare-Medicaid eligibles. On January 1, 2006 they must move from broader, more flexible Medicaid drug coverage to the narrower, extraordinarily complex Medicare drug benefit. Among those in jepordy are about a half million frail seniors and severely disabled persons served by state home- and...

Prescription Drug Coverage for HIV/AIDS: State ADAPs, Medicaid, and Medicare Part D

Many Americans living with HIV/AIDS receive critically important prescription drug coverage from state Medicaid programs. For these beneficiaries, Medicaid typically offers broad formularies, low cost sharing, and access to a large network of pharmacies. However, about 50,000 to 60,000 persons with HIV/AIDS will be losing Medicaid drug coverage on January 1, 2006. These dual eligibles will required to enroll in...

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