Dive Brief:
- New analysis of CMS for 2015 by healthcare analyst firm Avalere Health concludes that the number of Part D stand-alone prescription drug plans should fall by about 14%, from 1,169 this year to 1,001 next year.
- This reduction in plans, which is being caused primarily by consolidation among top plan sponsors like Aetna, CIGNA and UnitedHealth, should shift many beneficiaries into lower-cost plans, Avalere predicts. Average premiums should fall by 2% from $39.88 this year to $38.95 next year.
- Though premiums may decline for consumers, they may end up on the hook for higher costs. Avalere's analysis concludes that Part D plan sponsors may shift more cost-sharing requirements to enrollees.
Dive Insight:
As prescription drug plans work to shift more costs to beneficiaries, new plans could leave some of these beneficiaries without needed drugs that are too costly to pay for out-of-pocket. Given that the population Medicare serves is already sicker then the population as a whole, it's critical that CMS keep a close eye on whether these changes work to undermine the health of the chronically ill by putting drugs out of reach.
Still, consolidation of these plans seems to be having a positive effect on premiums for the near term, if a modest one. Not only have average premiums dropped by 2%, other PDP premiums are falling dramatically, including Aetna's Medicare RX Saver plan, a newly constituted plan that should drop premiums by more than 30%. Now the question becomes what the market dynamics will be if consolidation continues to this year and into 2015.