Date: Saturday, May 30, 2020
Session Time: 3:15pm-4:00pm
Presentation Time: 3:30pm-4:00pm
*Purpose: The Medicare open enrollment period is from Oct 15 to Dec 7, annually. The purpose of this project was to objectively measure the benefit of Part D plan evaluation for heart transplant (HT) recipients.
*Methods: Of 330 HT recipients who are actively followed at our center, 48% are insured by original Medicare, 11% Medicare Advantage, 3% Medicare + Medicaid, with the remaining 38% of patients covered by commercial insurance, Medicaid alone, or international/cash. The 160 patients insured by original Medicare had the opportunity to attend three open sessions, a live meeting, and/or a phone consultation for a Part D plan evaluation during the 2019 open enrollment period.
*Results: Patients were taking an average of 17 +/- 7 medications, and 12 +/- 5 were included in the Part D evaluation (medications billed to Part B and OTC medications were excluded). 28 drug plans were available for all patients based on their zip code. The estimated annual expense for Part D premiums and medication copays was $3,409.56 if all patients let their current plans roll forward into 2020, versus $1,605 if all patients changed to the best matched plan for 2020. Patients who changed from their current plan to the best matched plan saved an average of $3,075.16 +/- $3,325 over the course of the year. If the immunosuppressant medications were mis-allocated (i.e. included in the Part D evaluation when they shouldn’t have been or vice versa), it affected the best-matched plan 83% of the time. Approximately 1 hour per patient was required for the consultation, and approximately half of the patients elected to change their Part D plans as a result of this evaluation.
*Conclusions: This work demonstrates that evaluating the Part D plan every year during Medicare open enrollment is worthwhile and portends substantial savings to patients. Plan evaluation for transplant recipients must be performed by staff who will properly assign the immunosuppressant medications.
To cite this abstract in AMA style:Lourenco LM. The Importance of Annual Medicare Part D Plan Evaluation in Heart Transplantation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/the-importance-of-annual-medicare-part-d-plan-evaluation-in-heart-transplantation/. Accessed October 23, 2020.
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