|
|
|
The Medicare Modernization Act's most significant achievement is the introduction of Medicare Part D, a wide-ranging new outpatient prescription drug benefit. The massive increase in the number of Medicare Part D plans in 2007 demonstrates the health insurance industry's commitment to this new program. Lower premiums, zero deductibles, and an expansion of coverage in the coverage gap are all good news for beneficiaries. However, these changes reflect the intense struggle among insurers to gain an advantage in a highly competitive market. Get the Answers You Need to Shape Your Strategy Ninety percent of Medicare beneficiaries are currently enrolled in a Medicare Part D plan or equivalent. However, the number of Medicare Part D plans will increase sharply in 2007. What strategies are insurers employing to gain a competitive advantage in this market? The coverage gap is one of the most contentious features of Medicare Part D. Beneficiaries face unaffordable drug prices, and plans offering drug coverage in the gap carry steep premiums. The pharmaceutical industry is not immune to the effects of this initiative. How is the coverage gap threatening manufacturers of branded drugs? Medicare beneficiaries with special needs were historically viewed as an unwelcome liability for health plans. However, the Medicare Modernization Act introduced a risk adjustment model that offers greater rewards for managing an increasing number of chronic disorders through special needs plans (SNPs). What is the projected outlook for SNPs? Which insurers are at the forefront of this trend? The Medicare fee-for-service system is structured and financed to manage acute care episodes, not to manage and support individuals with progressive chronic diseases. However, a demonstration project called Medicare Health Support aims to improve the quality of care for beneficiaries who have multiple chronic illnesses. What are the components of this initiative? What is the outlook for the Medicare diseasemanagement market? Scope Medicare Modernization Act: overview and key changes in 2007. Current trends in available plans: prescription drug plans, Medicare advantage plans, employer-sponsored health plans, special needs plans, and Medicare medical savings accounts. Disease management: details the development of a demonstration project called the Medicare Health Support Program. Outlook and implications: how these trends are poised to affect the biopharmaceutical industry. Please note, the PDF e-mail from publisher version of this report is for a global site license. |
Additional Information
Companies Mentioned in This Spectrum Report
Aetna Life Insurance Company
American Healthways
American Progressive
Avalere Health
Aveta
Blue Cross/Blue Shield
Caremark Rx
Cigna Healthcare
EnvisionRx Plus
Express Scripts
Fleishman-Hillard
Gorman Health Group
Health Dialog
Health Net
Health Results Group
HealthSpring
Humana
LifeMasters Supported SelfCare
Longs Drug Stores
Mathematica Policy Research
McKesson Health Solutions
Medco Health Solutions
MemberHealth
NewQuest Health Solutions
NMHC Systems
The Segal Company
Torchmark
Unicare Life and Health Insurance
UnitedHealthcare
Universal American Financial
Visiting Nurse Service of New York
WellCare
WellPoint
XLHealth
