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Using Consumer Choice to Drive Value in Medicare’s Next Half-Century

August 06, 2015
3:45 pm

This summer, the nation has observed the 50-year anniversary of the Medicare program.  As we focus on Medicare’s next half-century and how we can ensure high-quality, accessible and affordable healthcare for tens of millions of current and future beneficiaries, it’s important that we have a clear understanding of what aspects of Medicare are working well in terms of elevating value.

The Medicare Today alliance recently released its annual survey, this one conducted by Morning Consult, of senior citizens throughout the country regarding their thoughts on Medicare Part D prescription drug coverage.  In existence now for just over a decade, Part D was one of the most important improvements to Medicare in the program’s history.  With a majority of older Americans coping with multiple chronic illnesses, it is impossible to overestimate the significance of this population having affordable access to prescription medications.

The survey of over 2,000 Americans over the age of 65 confirmed once again that Part D is fulfilling its mission.  Almost nine of every 10 seniors said they are satisfied with their Medicare drug coverage and 85 percent said the plan they selected delivers good value.  Eighty percent said their total out-of-pocket costs for their medications are reasonable.

The survey also found that seven of every 10 individuals receiving Medicare drug coverage said it is important for Part D to provide a selection of different coverage plans.

That last finding is significant.  There is an ongoing discussion in political circles regarding the private sector orientation of the Part D program.  Consumers have multiple plans from which to choose and drug prices are determined in private sector negotiations involving manufacturers, health plans and pharmacy benefit management firms.  This approach is clearly working well, exemplified not only by Part D’s popularity among seniors but also by the recent announcement by the Center for Medicare and Medicaid Services that average Part D monthly premiums would stay flat in 2016 at $32.50.

As we consider Medicare’s future, there are lessons to be learned here about the ability of consumer choice to drive quality, affordability and value.