Medicare modernization and the home care nurse: clarification of the prescription drug program and medicare advantage.
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The one-year prevalence of use of psychotropic medications among youths enrolled in a Mid-Atlantic State Children's Insurance Program (SCHIP) in 1999 or 2000 was compared with the 1998-2000 prevalence findings for youths enrolled in four large multistate private medical insurance programs. Prevalence was significantly higher among youths enrolled in the SCHIP than among those with private insurance in all eight medication group comparisons. Unlike private insurance, the surveyed state SCHIP program did not require a copayment or have a restrictive formulary. These administrative differences may partly explain the comparatively higher rate of psychotropic use under the SCHIP.
Despite a growing consensus that serious quality problems afflict U.S. health care, state and federal governments have done little to improve the quality of care. Proposed health insurance reforms, including a Medicare prescription drug benefit and the use of tax credits for insurance expansion, could create a mechanism for stimulating and then monitoring improvements in quality. We propose legislative requirements that any new expenditure of federal funds for health benefits be accompanied by public disclosure of performance information regarding quality, effectiveness, and safety. Such disclosure could yield diverse public and institutional benefits.
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The Medicare Rights Center has come up with a Top 10 list of questions consumers should ask before enrolling in an HMO. How prepared is your plan to answer these key questions?
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Senator Michael Kirby's committee says that the federal government should invest $6.5 billion more each year. It calls for the establishment of new national programs to pay for catastrophic drug costs and to expand home and palliative care.
As pharmacy benefits become an increasingly important component of rising health care costs, report cards critically need to be developed to inform consumers about the availability of their medications, what these medications cost them, and additional pharmacy benefit services that can enhance the management of their disease. This study is a preliminary step for developing such a card and assessing its impact on health plan enrollment choices in a small employee sample. Findings indicate that while individuals generally had positive comments about the pharmacy benefit report card, the card had little effect on their health plan enrollment decisions. The higher the prescription use reported by individuals, more likely they were to report that the card influenced their health plan enrollment decisions. The pharmacy benefit report card could be an useful tool for specific populations such as those with an increased need for medication.
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