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. 2008 Aug;48(4):432-41.
doi: 10.1093/geront/48.4.432.

Medicare part D and the nursing home setting

David G Stevenson  1 , Haiden A Huskamp, Joseph P Newhouse
Affiliations

Medicare part D and the nursing home setting

David G Stevenson et al. Gerontologist. 2008 Aug.

Abstract

Purpose: The purpose of this article is to explore how the introduction of Medicare Part D is changing the operations of long-term-care pharmacies (LTCPs) and nursing homes, as well as implications of those changes for nursing home residents.

Design and methods: We reviewed existing sources of information and interviewed stakeholders across various perspectives. We conducted 31 semistructured telephone interviews with key stakeholders between November 2006 and January 2007.

Results: Part D represents a substantial departure from how prescription drugs were previously financed and administered in nursing homes, and nursing home providers and LTCPs have struggled in adapting to some of these changes. Part D increased the variation around formularies and drug management processes for residents at the facility level, creating additional burden on clinical and pharmacy staff and introducing a tension between facilities' need to dispense medications quickly and assuring of coverage for those drugs. Nursing home and LTCP stakeholders perceive wide variation across Part D plans in their ability to meet the needs of nursing home residents.

Implications: Although LTCPs, nursing homes and their clinicians, and Part D plans will gain experience with the benefit in the nursing home setting over time, stakeholders we interviewed identified a range of longer term issues and questions that merit attention as the benefit proceeds.

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References

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    1. California HealthCare Foundation . The Medicare Drug Benefit: Impact on Nursing Facilities. Oakland, CA: CHCF; 2005.
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