- Since enactment of the Affordable Care Act, nearly 10.7 million Medicare beneficiaries have saved close to $20.8 billion on prescription drugs, CMS said.
- Last year alone saw more than $5.4 billion in savings for 5.2 million people, an increase over 2014’s $4.8 billion and 5.1 million beneficiaries.
- The ACA makes prescription drug coverage more affordable to seniors and people with disabilities by closing the Medicare Part D coverage gap, also known as the donut hole. The gap will be fully closed in 2020, CMS estimated.
Under the ACA, beneficiaries in the donut hole — the gap between the initial coverage limit and the catastrophic coverage threshold — received rebates and discounts on drugs purchased through Medicare Part D plans. This year, those savings and discounts will rise to 55% on brand drugs and 42% on generic drugs, according to CMS.
On average, beneficiaries saved about $1,945 on prescriptions since the ACA was enacted in 2010.
In addition to saving on drugs, roughly 39.2 million Medicare and Medicare Advantage beneficiaries used at least one preventive service at no out-of-pocket cost in 2015, and nearly 9 million had an annual wellness checkup.
The ACA was set up to improve outcomes and rein in healthcare costs by basing physician payments on actual outcomes and emphasizing a population approach to healthcare. Last year, CMS set a goal of 30% value-based Medicare payments by 2016 and 50% by 2018.