Transition to Medicare Part D: an early snapshot of barriers experienced by younger dual eligibles with disabilities.
OBJECTIVE
This study assessed the impact of transition from Medicaid drug coverage to Medicare Part D on a sample of dually eligible adults younger than age 65 years with disabilities.


METHODS
Telephone survey of employed adults participating in the Kansas Medicaid Buy-In program, Working Healthy, about their experiences in accessing medications after their transition to Part D.


METHODS
A total of 328 (55%) individuals from a random sample of 600 agreed to participate in a survey administered by a university-based research unit during February and March 2006, which included 18 questions with yes/no, multiple choice, and open-ended responses. Participants resembled other Kansas dual eligibles demographically and medically, other than having slightly higher rates of mental illness and lower rates of mental retardation and some physical conditions. Participants' 2004 Medicare and Medicaid claims data were analyzed to obtain an overview of their comorbidities and previous prescription use.


RESULTS
Twenty percent of participants reported difficulty obtaining medications, including drugs in Part D-protected classes; 13% were required to switch medications; and 8% stopped taking at least 1 medication. More than half did not know they could change plans monthly, potentially improving their access to medications.


CONCLUSIONS
The high incidence of access problems despite Centers for Medicare & Medicaid Services (CMS) safeguards points to the need for ongoing monitoring of Part D. If the problems persist, CMS must be willing to modify the program and/or better enforce the rules already in place to avoid adverse outcomes for beneficiaries with disabilities.
Hall
Jean P
JP
Division of Adult Studies, Center for Research on Learning, University of Kansas, 1122 West Campus Rd, Rm 517, Lawrence, KS 66045, USA. jhall@ku.edu
Kurth
Noelle K
NK
Moore
Janice M
JM
D000367:Age Factors; D000368:Aged; D000369:Aged, 80 and over; D006233:Persons with Disabilities; D011307:Drug Prescriptions / Q000191:economics*; D004608:Eligibility Determination / Q000191:economics / Q000331:legislation & jurisprudence; D005252:Fees, Pharmaceutical; D005260:Female; D019538:Health Care Surveys; D007722:Health Knowledge, Attitudes, Practice; D006297:Health Services Accessibility; D006801:Humans; D007356:Insurance, Pharmaceutical Services / Q000592:standards* / Q000639:trends; D007615:Kansas; D008297:Male; D008484:Medicaid / Q000191:economics* / Q000331:legislation & jurisprudence; D006278:Medicare / Q000191:economics* / Q000331:legislation & jurisprudence; D008875:Middle Aged; D012307:Risk Factors; D012424:Rural Population; D011795:Surveys and Questionnaires; D014481:United States; D014505:Urban Population