Prescription Drug Benefits

This Brief reviews the history and current status of federal special needs plans (SNPs) authority, with particular attention to provisions of interest to state Medicaid programs that have or are considering entering into contracts with SNPs to integrate or coordinate Medicaid long-term care services with Medicare primary, acute and prescription drug services for dually eligible beneficiaries.

U.S. Department of Health and Human Services

This Policy Brief helps fill an important gap in our understanding of medication patterns in long-term care facilities (LTCFs) by comparing use and spending for prescription and over-the-counter drugs during skilled nursing facility (SNF) stays and related non-qualifying long-term care facility episodes.

Contents Project Purpose Methods Findings Descriptive Analysis of Trends Findings Insight from Firm Discussions Benefits, Marketing, and Product Positioning Conclusions

This paper examines by state variation in drug prices and drug spending. Variation in prices are found to be minimal but variation in spending (and utilization) are more substantial. Further work will explore the underlying reasons for the spending variation and whether patterns persist when analyzed for areas other than states.

This paper describes the work NORC did to supplement the Federal Employee Health Benefits data (FEHBP) used to develop drug risk adjustment factors for over 65 individuals with a full drug supplement to Medicare. This data needed to be supplemented because the FEHBP data did not adequately represent, low-income, disabled, or non east Coast populations.

This contract developed data bases to supplement the Federal Employees Health Benefits Data used to develop the drug risk adjustment system for Medicare part D drug plans for low-income and disabled populations; explored geographic variation by state in drug prices and drug utilization; and examined the joint effects on drug plan risk of the combination of drug risk-adjustment, risk-corridors a

This report examines the consequences to medical innovation and overall health posed by attempts to contain drug expenditures by implementing government controls.