Managed Care - November 2008 - (Page 48)

MANAGED CARE OUTLOOK Fewer Part D options for low-income seniors ow-income seniors will have fewer Part D prescription drug plans to choose from in 2009, according to an analysis conducted by Avalere Health. Avalere found that 1.3 million low-income Medicare beneficiaries will be automatically reassigned by the end of 2008. Six states — Arizona, Florida, Hawaii, Maine, Nevada, and New Hampshire — will each have five or fewer plans available to automatically enroll lowincome residents in 2009. Humana continued its withdrawal from the low-income market, but United Healthcare expanded its presence in the market after losing 600,000 low-income beneficiaries last year. “United Healthcare lost enrollees between 2007 and 2008 because they lost the ability to enroll lowincome beneficiaries in several states,” says Bonnie L Washington, a vice president at Avalere Health. “For 2009, they will be able to regain the ability to enroll low-income beneficiaries in some of the states where they lost eligibility in 2008. We expect that their enrollment will go up in 2009 because they will have more states in which they are eligible to enroll low-income seniors.” Insurers have been turning their sights towards the dual eligibles — those eligible for both Medicare and Medicaid. Some have been expanding and others have been contracting their service to low-income seniors for 2009, says Washington. “The fundamental question for Medicare is whether lowincome beneficiaries end up in plans that do not fully meet their medical needs — especially given the fact that their choices are limited in many states,” says Washington. Low-income subsidy (LIS) beneficiaries will have fewer options with $0 premiums in 2009* 1,500 In nearly every state, LIS beneficiaries will have fewer options with $0 premiums in 2009 Change in number of plans with $0 premium for LIS beneficiaries, 2008–2009* All other plans 1,000 Plans with $0 premiums for LIS beneficiaries* 500 0 2007 2008 2009 ≤ −13 −9 to −12 −5 to −8 −1 to −4 0 Source: Avalere Health *Plans in which beneficiaries receiving the full low-income subsidy do not pay a premium. 48 MANAGED CARE / NOVEMBER 2008

Table of Contents Feed for the Digital Edition of Managed Care - November 2008

Managed Care - November 2008 Editor’s Memo Contents News and Commentary Legislation & Regulation Letters Medication Management Compensation Monitor Do It Yourself for Less Biomarkers Promise, but Do They Deliver? Oncologists Complain About Drug Payment Consider Blood Pressure Self-Monitoring Q&A: Keep Industry in the Game Formulary Files Plan Watch Tomorrow’s Medicine Outlook Respiratory Syncytial Virus Managed Care Considerations Contents Continuing Education Objectives RSV Disease in the Pediatric Population In the Trenches RSV Infection in the Adult Population Health Plan Medical Director Health Plan Pharmacy Director RSV Issues and Solutions Assessment/Evaluation/Certificate Request Post-Test

Managed Care - November 2008

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