Date: Saturday, May 30, 2020
Session Name: Poster Session C: Non-Organ Specific: Economics & Ethics
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 transplant recipients.
*Methods: Of 135 lung transplant recipients who are actively followed at our center, 31% are insured by original Medicare, 9% Medicare Advantage, 15% Medicare + commercial, 13% Medicare + Medicaid, 22% commercial, 9% Medicaid, and 1% international/cash. The 42 patients insured by original Medicare had a live or phone consultation for a Part D plan evaluation during the 2019 open enrollment period.
*Results: Patients were taking an average of 15 +/- 5 medications; 9 +/- 4 were included in the Part D evaluation (medications excluded from the evaluation include those billed to Part B, available OTC, or obtained through manufacturer assistance programs). The projected annual expense for Part D premiums and medication copays was $2,472 +/- $2,969 if all patients let their current plans roll forward into 2020, versus $1,308 +/- $1,446 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 $1,106 +/- $1,950 or 34 +/- 25% over the course of the year. If the immunosuppressant medications were mis-allocated (i.e. included in the Part D evaluation when they should not have been or vice versa), it affected the best-matched plan 70% of the time. Approximately 1 hour per patient was required for the consultation, patients had approximately 28 plans to choose from (varied slightly by zip code), and approximately half of the patients elected to change their Part D plans as a result of this evaluation. The average monthly premium for the 2020 plans is $22.90 + $13.86.
*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:Potter L, Garrity E. The Importance of Annual Medicare Part D Plan Evaluation [abstract]. Am J Transplant. 2020; 20 (suppl 3). https://atcmeetingabstracts.com/abstract/the-importance-of-annual-medicare-part-d-plan-evaluation/. Accessed October 23, 2020.
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