If you can’t make money at it, the free market isn’t going to provide it. And therein lies an important challenge for healthcare. An analysis by Avalere Health (Washington) shows that the number of stand-alone Prescription Drug Plans qualified to serve low-income Medicare beneficiaries (i.e., dual eligible Medicare/Medicaid members) in 2009 will fall to just 308, a decline of nearly 200 from this year. That means some 1.2 million low-income PDP members will be reassigned because their current plan is no longer available.
“Pursuit of the dual eligible is now a matter of business strategy for insurers—with some expanding and some diminishing their service to low-income beneficiaries in 2009,” said Bonnie Washington, vice president of Avalere Health. “The fundamental question for Medicare is whether low-income beneficiaries [end] up in plans that do not fully meet their medical needs—especially given the fact that their choices are limited in many states,” she said. In addition to PDPs, members can also choose a Medicare Advantage plan with drug coverage.
According to Avalere, six states will have five or fewer PDPs in 2009—Arizona, Florida, Hawaii, Maine, Nevada and New Hampshire. Nevada has the fewest choices: one. Wisconsin has the most: 16.
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