Document Type

Master's Culminating Experience

Publication Date

2009

Abstract

Objectives: Since previous research was fragmented and incomplete, I described changes in the benefit designs of stand-alone PDPs in the United States from 2006 through 2009. In addition, I identified trends in the PDP market of Ohio and compared them to the national data. The intent was to discover changes that might only be observed during the examination of a smaller market. I then presented the enrollment data of stand-alone PDPs in Ohio and discussed the benefit designs of popular plans to help further understand the PDP market dynamics.

Methods: Each year, CMS collected and released information on benefit characteristics of standalone PDPs in November 2005, November 2006, September 2007, and September 2008. In this research, I reported on the number of PDPs available (dependent variable) in Ohio and the United States and the benefit characteristics of those PDPs (independent variables). I provided summary statistics on the following independent variables: type of benefit, LIS, premium, deductible, and gap coverage. Additionally, I highlighted the enrollment of PDPs and the benefit characteristics of those PDPs.

Results: I found that from 2006 to 2009, the benefit characteristics of PDPs in Ohio compared to national data were similar across all variables. Though PDP availability peaked in 2007, there remained a greater number of PDPs available in 2009 than there had been in 2006. Meanwhile, from 2006 to 2009, there was a gradual decline in plans available for low-income-subsidy. The average premium increased every year from 2006 to 2009. In 2009, the unweighted average of PDPs in Ohio was $44.33, while the average premium of the most popular PDPs was $32.47. From 2006 to 2009, there was an increase in PDPs offering more coverage during the gap, although, in Ohio, none of the most popular plans offered gap coverage. Gap coverage is defined by CMS as the period of time in which Part D enrollees were responsible for the full cost of their prescription medications drugs until they qualified for catastrophic coverage.

Conclusions: Results indicate that in 2009, PDP availability for beneficiaries who voluntarily chose their plan was greater than at any previous time. Additionally, disproportionate to the amount of plans offered, individuals enrolled in PDPs offering low premiums and PDPs without gap coverage. As well, a relatively small number of PDPs available nationwide dominated the market share. Research suggests possible policy changes in Part D concerning cost, benefit design, and availability.

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