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Medicare Part D Research Project and Related Topics
Publications and Articles
The Medicare Part D Research Project, headed by Jack Hoadley and Laura Summer, conducts research on the Medicare Part D prescription drug benefit, as well as related topics on prescription drug benefits in other settings and other Medicare policy issues. Many of our studies are conducted in conjunction with colleagues at Georgetown and other research organizations.
Our work in this field has been supported by:
The Medicare Part D benefit was enacted into law as part of the Medicare Modernization Act of 2003 and implemented starting in 2006. It operates through stand-alone private prescription drug plans, or PDPs, as well as Medicare Advantage plans that offer both medical and prescription drug coverage through a managed care organization (MA-PDs). In most states, beneficiaries can choose from at least 50 different stand-alone PDPs, and varying numbers of MA-PDs. There will be 1,689 separate PDPs and 2,099 MA-PDs offered across the country in 2009. Plans can offer either a standard or enhanced benefit plan, which allows plans to vary in the premiums, deductibles, copayments and levels of coverage offered. Medicare beneficiaries with low incomes and limited resources may qualify for Extra Help, a subsidy that covers most of the costs associated with the Part D benefit.
MEDICARE PART D
Medicare Part D: General
- Jack Hoadley, "Data-Driven Drug Coverage. Harnessing Information for a Better Medicare Prescription Drug Program." The Center for American Progress, December 2008.
- Jack Hoadley, "Medicare Part D: Simplifying the Program and Improving the Value of Information for Beneficiaries." The Commonwealth Fund, May 2008.
- Jack Hoadley, "Medicare's New Adventure: The Part D Drug Benefit." (Powerpoint) Presentation at Cornell University, April 27, 2007.
- Jack Hoadley, "Medicare's New Adventure." The Commonwealth Fund, March 2006.
- Jack Hoadley, Statement on the Medicare Drug Benefit. (PDF) Testimony before the House Committee on Oversight and Government Reform, January 20, 2006.
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Medicare Part D Benefit Offerings, Premiums and Trends
2010 Benefits
2009 Benefits
- Elizabeth Hargrave, Jack Hoadley, Juliette Cubanski, and Tricia Neuman, "Medicare Prescription Drug Plans in 2009 and Key Changes Since 2006: Summary of Findings." The Henry J. Kaiser Family Foundation, June 2009.
- MedPAC, Report to the Congress: Medicare Payment Policy. Chapter 4, "A Status Report on Part D for 2009." (PDF) March 2009. Analysis contributing to this chapter was conducted by Jack Hoadley, Elizabeth Hargrave and Katie Merrell.
- Jack Hoadley, Elizabeth Hargrave, Katie Merrell and Lan Zhao, "Medicare Part D Benefit Designs and Formularies, 2006-2009." (PDF) Presentation to MedPAC, December 5, 2008.
- Jack Hoadley, Jennifer Thompson, Elizabeth Hargrave, Juliette Cubanski and Tricia Neuman, "Medicare Part D 2009 Data Spotlight: Premiums." The Henry J. Kaiser Family Foundation, November 2008.
2008 Benefits
- Jack Hoadley, Elizabeth Hargrave, Juliette Cubanski and Tricia Neuman, "Medicare Prescription Drug Plans in 2008 and Key Changes Since 2006: Summary of Findings." The Henry J. Kaiser Family Foundation, April 2008.
- Jack Hoadley, Elizabeth Hargrave, and Katie Merrell, "Methodology Appendix to the Medicare Part D 2008 Data Spotlights." The Henry J. Kaiser Family Foundation, January 2008.
- Jack Hoadley, Elizabeth Hargrave, Katie Merrell, Juliette Cubanski and Tricia Neuman, "Medicare Part D 2008 Data Spotlight: Benefit Design." The Henry J. Kaiser Family Foundation, December 2007.
- Jack Hoadley, Jennifer Thompson, Elizabeth Hargrave, Katie Merrell, Juliette Cubanski and Tricia Neuman, "Medicare Part D 2008 Data Spotlight: Premiums." The Henry J. Kaiser Family Foundation, November 2007.
2007 Benefits
- MedPAC, Report to the Congress: Medicare Payment Policy. Chapter 4, "Part D, Enrollment, Benefit Offerings and Plan Payments." (PDF) March 2008. Analysis contributing to this chapter was conducted by Jack Hoadley, Elizabeth Hargrave and Katie Merrell.
- Jack Hoadley, Elizabeth Hargrave and Katie Merrell, "Medicare Part D Formularies, 2006-2007." (PDF) Presentation to MedPAC, November 8, 2007.
- Jack Hoadley, Elizabeth Hargrave, Katie Merrell, Juliette Cubanski, and Tricia Neuman, "Benefit Design and Formularies of Medicare Drug Plans: A Comparison of 2006 and 2007 Offerings." The Henry J. Kaiser Family Foundation, November 2006.
2006 Benefits
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Medicare Part D Coverage Gap
- Jack Hoadley, Laura Summer, Elizabeth Hargrave, Juliette Cubanski and Tricia Neuman,"Medicare Part D 2010 Data Spotlight: The Coverage Gap." The Henry J. Kaiser Family Foundation, November 2009.
- Jack Hoadley, Jennifer Thompson, Elizabeth Hargrave, Juliette Cubanski and Tricia Neuman,"Medicare Part D 2009 Data Spotlight: The Coverage Gap." The Henry J. Kaiser Family Foundation, November 2008.
- Jack Hoadley, Elizabeth Hargrave, Juliette Cubanski and Tricia Neuman, "The Medicare Part D Coverage Gap: Costs and Consequences in 2007." The Henry J. Kaiser Family Foundation, August 2008.
- Jack Hoadley, Jennifer Thompson, Elizabeth Hargrave, Katie Merrell, Juliette Cubanski and Tricia Neuman, "Medicare Part D 2008 Data Spotlight: The Coverage Gap." The Henry J. Kaiser Family Foundation, November 2007.
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Medicare Part D Formularies
- Elizabeth Hargrave, Jack Hoadley, Juliette Cubanski, and Tricia Neuman, "Medicare Part D 2009 Data Spotlight: Ten Most Common Brand-Name Drugs." The Henry J. Kaiser Family Foundation, June 2009.
- Jack Hoadley, Elizabeth Hargrave, Juliette Cubanski, and Tricia Neuman, "Medicare Part D 2009 Data Spotlight: Specialty Tiers." The Henry J. Kaiser Family Foundation, June 2009.
- Elizbeth Hargrave, Jack Hoadley and Katie Merrell, "Drugs on Specialty Tiers." (PDF) Contractor Report for MedPAC, February 2009.
- Elizabeth Hargrave, Jack Hoadley, Katie Merrell and Juliette Cubanski, "Medicare Part D 2008 Data Spotlight: Ten Most Common Brand-Name Drugs." The Henry J. Kaiser Family Foundation, April 2008.
- Jack Hoadley, Elizabeth Hargrave, Katie Merrell, Juliette Cubanski and Tricia Neuman, "Medicare Part D 2008 Data Spotlight: Formularies." The Henry J. Kaiser Family Foundation, January 2008.
- Jack Hoadley, Elizabeth Hargrave, Katie Merrell, Tricia Neuman and Juliette Cubanski, "Medicare Part D 2008 Data Spotlight: Utilization Management." The Henry J. Kaiser Family Foundation, January 2008.
- Elizabeth Hargrave, Jack Hoadley, Katie Merrell, and Juliette Cubanski, "Medicare Part D 2008 Data Spotlight: Specialty Tiers." The Henry J. Kaiser Family Foundation, December 2007.
- Jack Hoadley, Katie Merrell, Elizabeth Hargrave and others, "Issues in the Design and Implementation of Drug Formularies and Therapeutic Classes." Report submitted to the Office of the Assistant Secretary for Planning and Evaluation, DHHS, by NORC at the University of Chicago and Georgetown University, September 2005.
- Jack Hoadley, "The Effects of Formularies and Other Cost Management Tools on Access to Medications: An Analysis of the MMA and the Final Rule." The Henry J. Kaiser Family Foundation, March 2005.
- Jack Hoadley, "The Effect of Formularies and Other Cost Management Tools on Access to Medications: An Analysis of the MMA and Proposed Regulations." The Henry J. Kaiser Family Foundation, September 2004.
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Medicare Part D and Low-income Beneficiaries
- Laura Summer, Jack Hoadley, Elizabeth Hargrave, Juliette Cubanski and Tricia Neuman, "Medicare Part D 2009 Data Spotlight: Low-Income Subsidy Plan Availability." The Henry J. Kaiser Family Foundation, November 2008.
- Jack Hoadley, Elizabeth Hargrave, Katie Merrell and Laura Summer, "Beneficiary-Centered Assignment and Medicare Part D." (PDF) Presentation to MedPAC, September 4, 2008.
- Laura Summer, "Seniors at Risk: Improving Medicare for Our Most Vulnerable." (PDF) Testimony before the Special Committee on Aging, United States Senate, May 22, 2008.
- Laura Summer, Patricia Nemore, and Jeanne Finberg, "Medicare Part D: How do Vulnerable Beneficiaries Fare?" The Commonwealth Fund, May 2008.
- Laura Summer, Ellen O'Brien, Patricia Nemore and Katharine Hsiao, "Medicare Part D: State and Local Efforts to Assist Vulnerable Beneficiaries." The Commonwealth Fund, May 2008.
- Jack Hoadley, Elizabeth Hargrave, and Juliette Cubanski, "Medicare Part D 2008 Data Spotlight: Low-Income Subsidy." The Henry J. Kaiser Family Foundation, April 2008.
- Laura Summer, "Medicare Part D: How Are Vulnerable Beneficiaries Faring?" Presentation at the Alliance for Health Care Reform, November 5, 2007.
- Jack Hoadley, Laura Summer, Jennifer Thompson, Elizabeth Hargrave and Katie Merrell, "The Role of Beneficiary-Centered Assignment for Medicare Part D." (PDF) Contractor report for MedPAC, June 2007.
- Laura Summer, Patricia Nemore and Jeanne Finberg, "Improving the Medicare Part D Program for the Most Vulnerable Beneficiaries." The Commonwealth Fund, May 2007.
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Medicare Part D Enrollment and Beneficiary Education
- Elizabeth Hargrave, Bhumika Piya, Jack Hoadley, Laura Summer, and Jennifer Thompson, " Experiences Obtaining Drugs under Part D: Focus Groups with Beneficiaries, Physicians, and Pharmacists." (PDF) Contractor report for MedPAC, March 2008.
- MedPAC, Report to Congress. Increasing the Value of Medicare. Chapter 8, "How beneficiaries learned about the drug benefit and made plan choices." (PDF) June 2006. Analysis contributing to this chapter was conducted by Jack Hoadley, Laura Summer, Marc Berk, Karen Cheung, Elizabeth Eaton, Dan Gaylin, Elizabeth Hargrave, Sarah Hughes and Alma Kuby.
- MedPAC, Report to Congress. Issues in a Modernized Medicare Program. Chapter 1, "Monitoring the Implementation of Part D." (PDF) June 2005. Analysis contributing to this chapter was conducted by Jack Hoadley, Elizabeth Hargrave, and Ellen O'Brien.
- MedPAC, Report to the Congress: New Approaches in Medicare.Chapter 1, "Implementing the Medicare drug benefit: Formulary and plan transition issues." (PDF) June 2004. Analysis contributing to this chapter was conducted by Jack Hoadley, Jennifer Benz, Dan Gaylin, Alana Ketchel, Susan Rogers Mathieu, Adil Moiduddin, and Ellen O'Brien.
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Medicare Part D Claims Data
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Performance Measures
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Prescription Drugs under Medicaid and State Pharmacy Assistance Programs.
- Jack Hoadley and Joan Alker, "Uncertain
Access to Needed Drugs: Florida's Medicaid Reform Creates Challenges for Patients." Briefing #3, Jessie Ball
duPont Fund, July 2007.
- Jack Hoadley, Elizabeth Eaton, Leigh Ann White, Alana Ketchel, Alma Kuby, and Zein Malas, "Access to Chemotherapy Services for Medicare Beneficiaries: Summary of Focus Groups with Beneficiaries." Contractor report for MedPAC, March 2006.
- David Bergman, Jack Hoadley, Neva Kaye, Jeffrey Crowley, and Martha Hostetter, "Using Clinical Evidence to Manage Pharmacy
Benefits: Experiences of Six States." Issue Brief, The Commonwealth Fund, March 2006.
- Jack Hoadley, Jeffrey Crowley, David Bergman, and Neva Kaye, "Understanding Key Features of the Drug Effectiveness Review Project (DERP)
and Lessons for State Policy Makers." (PDF) Issue Brief, National Academy for State Health Policy, March 2006.
- David Bergman, Neva Kaye, Jack Hoadley and Jeffrey Crowley, "State Experience in Creating Effective P&T
Committees." (PDF) Issue Brief, National Academy for State Health Policy, March 2006.
- David Bergman, Neva Kaye, Jack Hoadley and Jeffrey Crowley, "State Design and Use of Prior Authorization
Processes." (PDF) Issue Brief, National Academy for State Health Policy, March 2006.
- David Bergman, Neva Kaye, Jack Hoadley and Jeffrey Crowley, "State Efforts to Manage the Behavioral Health Pharmaceutical
Benefit." (PDF) Issue Brief, National Academy for State Health Policy, March 2006.
- Sarah Goodell, Jack Hoadley, Ellen O'Brien, and Claudia Williams, "State Pharmacy Assistance Programs vs Medicare Prescription Drug Plans: How Do They Contain Rising Costs?" (PDF) Policy Brief, Robert Wood Johnson Foundation, Changes in Health Care Financing and Organization initiative, October 2005.
- Claudia Williams, Sarah Goodell, Jack Hoadley, Ellen O'Brien, and Matt Kanter, "State Pharmacy Assistance Programs at a Crossroads: How Will They Respond to the Medicare Drug Benefit?" (PDF) Policy Brief, Robert Wood Johnson Foundation, Changes in Health Care Financing and Organization initiative, July 2005.
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MEDICARE SAVINGS PROGRAMS (QMB, SLMB, AND QI)
- MedPAC, Report to the Congress: Medicare Payment Policy. Chapter 5, "Increasing participation in the Medicare Savings Programs and the low-income drug subsidy." (PDF) March 2008. Analysis contributing to this chapter was conducted by Laura Summer.
- Laura Summer, "Accomplishments and Lessons from the State Solutions Initiative to Increase Enrollment in the Medicare Savings Programs." (PDF) State Solutions, The Robert Wood Johnson Foundation and the Commonwealth Fund, May 2006.
- Laura Summer, "Administrative Costs Associated with Enrollment and Renewal for the Medicare Savings Programs: A Case Study of Practices in Minnesota." (PDF) State Solutions, The Robert Wood Johnson Foundation and the Commonwealth Fund, February 2006.
- Laura Summer, "Administrative Costs Associated with Enrollment and Renewal for the Medicare Savings Programs: A Case Study of Practices in New Hampshire." (PDF) State Solutions, The Robert Wood Johnson Foundation and the Commonwealth Fund, February 2006.
- Laura Summer and Emily Ihara, "Simplifying Enrollment in Medicaid and Medicare Savings Programs for the Elderly and Individuals with Disabilities." (PDF) The AARP Public Policy Institute, December 2005.
- Laura Summer, "Administrative Costs Associated with Enrollment and Renewal for the Medicare Savings Programs: A Case Study of Practices in Louisiana." (PDF) State Solutions, The Robert Wood Johnson Foundation and the Commonwealth Fund, 2004.
- Laura Summer and Lee Thompson, "How Asset Tests Block Low-Income Medicare Beneficiaries from Needed Benefits." The Commonwealth Fund, May 27, 2004.
- Laura Summer and Robert Friedland, "The Role of the Asset Test in Targeting Benefits for Medicare Savings Programs." The Commonwealth Fund, October 2002.
- Laura Summer, "Increasing Enrollment for the Medicare Savings Programs." Center for Medicare Education 2(7), 2001.
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PROMOTING ENROLLMENT IN BENEFIT PROGRAMS
- Laura Summer, "Retaining Benefits: An Important Aspect of Increasing Enrollment." National Council on Aging, August 2009.
- Laura Summer, "Express Lane Eligibility: New Strategies for Increasing Enrollment." National Council on Aging, June 2009.
- Laura Summer, "Increasing Participation in Benefit Programs for Low-Income Seniors." The Commonwealth Fund, April 2009.
- Laura Summer, "Getting and Keeping Coverage: States' Experience with Citizenship Documentation Rules." (PDF) THe Commonwealth Fund, January 2009.
- Laura Summer and Jennifer Thompson, "Best Practices to Improve Take-Up Rates in Health Insurance Programs." Prepared for the Office of the Assistance Secretary for Planning and Evaluation (ASPE), U.S. Department of Health and Human Services, August 18, 2008.
- Laura Summer and Cindy Mann, "Instability of Public Health Insurance Coverage for Children and Their Families: Causes, Consequences and Remedies." (PDF) The Commonwealth Fund, June 2006.
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MEDICARE BENEFICIARY EXPERIENCE
- Elizabeth Hargrave, Jack Hoadley, Sophie Miller, Laura Summer and Jennifer Thompson, "Beneficiaries, Their Physicians, and Supplemental Coverage: Findings from Focus Groups in August and September 2008." Contractor Report for MedPAC, forthcoming.
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MEDICARE PART B
- Elizabeth Hargrave, Jack Hoadley and Jennifer Thompson, "Coverage and Pricing of Drugs That Can Be Covered Under Part B and Part D."(PDF) Contractor Report for MedPAC, October 2007.
- Daniel Gaylin, Michael Gluck, Jack Hoadley and Sarah Townsend, "Physician Administered Drugs: Distribution and Payment Issues in the Private Sector." (PDF) Contractor report for MedPAC, August 2003.
- Isadora Gil, Michael Gluck, Jack Hoadley, Adil Moiduddin, Robert Rubin and Sarah Townsend, " Drugs in the Development Pipeline: Impact on Part B Medicare Spending." (PDF) Contractor report for MedPAC, August 2003.
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MEDICARE ADVANTAGE
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OTHER PRESCRIPTION DRUGS
- Jack Hoadley, Statement on the VA National Formulary. Testimony before the House Committee on Veterans' Affairs, September 22, 2009.
- Jack Hoadley, "How Can We Tell If Prescription Drug Prices Are Too High?" Presentation to the Institute of Medicine Roundtable on Evidence-Based Medicine, May 2009.
- Jack Hoadley, "The Prescription Drug Safety Net: Access to Pharmaceuticals for the Uninsured." (PDF) Background Paper, National Health Policy Forum, May 9, 2007.
- Claudia Schur, Lan Zhao, Katie Merrell, Elizabeth Hargrave, Jack Hoadley and Chris Hogan, "Continuation of Drug Risk Adjustment: Final Report." (PDF) Report submitted to the Office of the Assistant Secretary for Planning and Evaluation, DHHS, by NORC at the University of Chicago and Georgetown University, December 2006.
- Elizabeth Hargrave and Jack Hoadley, "Geographic Variation in Prescription Drug Prices and Spending." (PDF) Report submitted to the Office of the Assistant Secretary for Planning and Evaluation, DHHS, by NORC at the University of Chicago and Georgetown University, October 2005.
- Claudia Schur, Jack Hoadley and others, "Evaluation of Data Bases for Drug Risk Adjustment." Report submitted to the Medicare Payment Advisory Commission by NORC at the University of Chicago and Georgetown University, March 2005.
- Jack Hoadley, "Cost Containment Strategies for Prescription Drugs:
Assessing the Evidence in the Literature." Henry J. Kaiser Family Foundation, March 2005.
- Jack Hoadley, "The Continuing Need for
Independent Research on Prescription Drugs (Grantwatch)," Health Affairs, vol. 23, no. 1 (January/February 2004), pp. 244-249.
- Department of Health and Human Services (Jack Hoadley, team leader), "Prescription Drug Coverage, Spending, Utilization and Prices." Report to the President, April 2000.
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LONG-TERM SERVICES AND SUPPORTS
- Laura Summer, "Efforts in States to Promote Medicaid Community-Based Services and Supports" The Henry J. Kaiser Family Foundation, September 2009.
- Laura Summer, "Community-based Long-term Services Financed by Medicaid: Managing Resources to Provide Appropriate Medicaid Services." (PDF) Georgetown University Health Policy Institute, June 2007.
- Laura Summer, "Strategies to Keep Consumers Needing Long-Term Care in the Community and Out of Nursing Facilities." Kaiser Family Foundation, October 2005.
- Laura Summer and Emily Ihara, "The Medicaid Personal Care Services Benefit, Practices in States that Offer the Optional State Plan Benefit." AARP Public Policy Institute, August 2005.
- Laura Summer and Emily Ihara, "State-Funded Home and Community-Based Service Programs for Older People." AARP Public Policy Institute, October 2004.
- Laura Summer, "Choices and consequences: The Availability of Community-based Long-term Care Services to the Low-income Population." (PDF) Georgetown University Health Policy Institute, May 2003.
- Laura Summer, "State-funded Home and Community Based Service Programs." (PDF) National Governors' Association, March 2001.
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