CMS selects 6 insurers for Medicare Part D medication model

Six health insurers were chosen for CMS' Medicare Part D Enhanced Medication Therapy Management pilot, set to begin Jan. 1.

The five-year medication management model will offer financial incentives for basic Part D prescription drug plans to provide innovative medication management programs in lieu of standard CMS medication management plans. The model will examine the effectiveness of selected Medicare Prescription Drug Plans at achieving the overall goals for medication therapy management like medication adherence, addressing barriers to prescription drug usage and fostering communication between prescribers and patients.  

An estimated 1.6 million beneficiaries are expected to enroll over all participating plans.  

Here are the six insurers selected for the model with their corresponding regions. 

  • Blue Cross and Blue Shield of Florida — Florida
  • Blue Cross and Blue Shield Northern Plains Alliance — Great Plains Region (Iowa, Minnesota, North Dakota, South Dakota, Nebraska, Wyoming, and Montana)
  • CVS Health — Arizona, Florida, Louisiana, Virginia, Great Plains Region
  • Humana — Arizona, Florida, Louisiana, Virginia, Great Plains Region
  • UnitedHealthcare — Arizona, Florida, Louisiana, Virginia, Great Plains Region
  • WellCare — Arizona, Florida, Louisiana, Virginia, Great Plains Region 

Metrics such as variation in market competition, geographical range, population, market characteristics and Parts A and B spending variances will be used to determine the model's regional success in improving therapeutic outcomes. 

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