On January 1, 2006, the Medicare program began offering prescription drug coverage (Medicare Part D) to over 42 million Medicare beneficiaries. This policy brief provides a first snapshot of enrollment in rural and urban areas across the United States and outlines the early findings from an analysis of plans available to rural persons under Medicare's Part D program. The data in this brief will...

1. Unified Beneficiaries Database In 2003, a unified Beneficiaries Database was created, including beneficiaries of the Ministry of Public Health (MOPH), National Social Security Fund (NSSF), Civil Servants Cooperative (CSC), Army, Internal Security Forces (ISF), General Security Forces (GSF) and State Security Forces (SSF). The unification of beneficiaries information implied that doublecovera...

Efforts to study racial variations in access to health care for minorities other than black persons have been hampered by a paucity of data. The Health Care Financing Administration (HCFA) has made efforts in the past few years to enhance the racial codes on the Medicare enrollment files to include Hispanic, Asian American, and Native American designations. This study examines hospitalization r...

The Medicare+Choice (M+C) program has faced successive waves of plan withdrawals since 1999. We collected data from 1,055 beneficiaries who were involuntarily disenrolled from a health maintenance organization (HMO) that withdrew from six large markets in 1999 to investigate how they were impacted by the forced change in coverage. Administrative data from this HMO were used to oversample benefi...

BACKGROUND Medicare Part D, introduced in January 2006, was intended to decrease beneficiaries' out-of-pocket expenditures on medications. METHODS We examined whether this policy was successful in achieving this goal, including effects on Medicare beneficiaries without previous drug coverage and those who previously received coverage through Medicaid, in a longitudinal study of out-of-pocket ...

OBJECTIVE To determine the effect of joining HMOs (health maintenance organizations) on the inpatient utilization of Medicare beneficiaries. DATA SOURCES We linked enrollment data on Medicare beneficiaries to patient discharge data from the California Office of Statewide Health Planning and Development (OSHPD) for 1991-1995. DESIGN AND SAMPLE A quasi-experimental design comparing inpatient ...

BACKGROUND The association between the Medicare Part D low-income subsidy (LIS), gap coverage, and outcomes such as medical expenditures, prescription fills, and medication adherence is not well understood. The purpose of this study was to examine the relationship between the LIS and these measures for patients within a large, national Part D plan in the United States. METHODS In this cross-s...

Participation provide a unique opportunity to identify major types of Social Security beneficiaries and to characterize their relative socioeconomic status. Five types of beneficiaries are identified: the two types of worker beneficiaries (retired workers and disabled workers), and the three major groups with benefits based on someone else’s work record (aged wives, aged widows, and minor child...

BACKGROUND Findings from previous studies on an association between obesity and colorectal cancer (CRC) screening are inconsistent and very few studies have utilized national level databases in the United States (US). METHODS A cross-sectional study was conducted using data from the 2005 Medicare Current Beneficiary Survey to describe CRC screening rate by obesity status. RESULTS Of a 15,76...

OBJECTIVE To evaluate the impact of Medicare Part D coverage gap (donut hole) on adherence to diabetes medications. STUDY DESIGN Retrospective cohort analysis based on pharmacy claims data. METHODS The sample included 12,881 Medicare Part D beneficiaries with diabetes who entered the coverage gap in 2008. Sample patients had 3 different levels of coverage in the donut hole: no coverage, gen...