3102.0 Medicare/Medicaid Policy

Monday, October 29, 2012: 10:30 AM - 12:00 PM
The presentations of this session are related to various issues related to Medicare/Medicaid policies for the older adults, including a study examined whether quality indicators reported to CMS by Medicare-certified HHC agencies are equal in areas with higher levels of NA/AN residents; a study prospectively examined the relationship between stand-alone prescription drug plan (PDP) costs, subsidy status, and the number of plans offered in California from 2009-2012; an analysis utilizes Illinois Medicaid claims and enrollment data from Jan 1, 2004 to Dec 31, 2010; a study determined whether the MTM eligibility criteria would perform better in the future by examining the historical trend of MTM disparities from 1996-1997 to 2007-2008; as well as an evaluate the second year experience of a High Risk Case Management (HRCM) pilot program.
Session Objectives: 1. Describe the evaluation of a high risk case management program for older adults with Medigap insurance from a financial and quality of care perspective. Discuss analyses used and results of the second year of the program. 2. Evaluate the need for policy alternatives that seek to eliminate gaps in the quality of care provided in rural and NA/AN areas. 3. Describe the relationship between drug plan costs, subsidy status, and plan offerings. Describe the importance of annual plan reexamination and the potential consequences of failure to do so. 4. Describe the eligibility criteria for medication therapy management (MTM) services, compare the likelihood of meeting MTM eligibility criteria across racial and ethnic groups, and Analyze the historical trend of the disparity patterns in meeting MTM eligibility criteria.

Evaluation of a High Risk Case Management Pilot Program for Medicare Beneficiaries with Medigap Coverage
Kevin Hawkins, PhD, Ronald J. Ozminkowski, PhD, Gandhi R. Bhattarai, PhD, Paula Parker, MBA, RN, Jinghua Huang, PhD, Timothy Wells, MPH, PhD, Richard J. Migliori, MD and Charlotte S. Yeh, MD
Lower quality of Medicare-certified home health care in areas with high levels of Native American/Alaska Native residents
Samuel Towne, MPH, CPH, Janice C. Probst, PhD, Jordan Mitchell, MBA and Zhimin Chen, MS
Medicare Part D plan optimization: The need for an annual check-up
Rajul A. Patel, PharmD, PhD, Mark P. Walberg, PharmD, PhD, Nataliya McElroy, BS, PharmD Candidate 2013, Anil Mallya, BS, PharmD Candidate 2013, Aesun Kim, PharmD Candidate 2013, Yvonne Mai, PharmD Candidate 2013, Justin Seo, PharmD Candidate 2013, Joseph A. Woelfel, PhD, RPh, Sian M. Carr-Lopez, PharmD and Suzanne M. Galal, PharmD
A cost saving evaluation of Ilinois Medicaid Patient Centered Medical Home program
Robert Phillips, MD MPH, Meiying Han, PhD, Stephen Petterson, PhD, Laura Makaroff, MD and Winston Liaw, MD MPH

See individual abstracts for presenting author's disclosure statement and author's information.

Organized by: Aging & Public Health
Endorsed by: Health Administration, American Indian, Alaska Native and Native Hawaiian Caucus

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