Seniors in the Donut Hole Have Already Saved $166 Million on Prescription Drugs

By Jonathan Blum, Deputy Administrator and Director, Center for Medicare & Medicaid. Crosspost from Healthcare.gov

The Affordable Care Act is cutting the cost of prescription drugs for millions of people with Medicare. Starting this year, people with Medicare receive a 50% percent discount on covered brand name drugs bought when they are in the donut hole.

To receive the discount, no special action is required. Seniors simply purchase drugs at the pharmacy and receive the discount automatically.

So far, 271,000 people have used the discounts to save an average of $613 for a total of $166 million. These savings will continue to grow.  Most people who reach the donut hole do so later in the year, so we know more and more seniors will be helped as the year progresses.  But seniors with high costs are already receiving critical relief from prescription drug costs.

Most of these discounts are helping seniors with serious medical conditions – nearly 20% of the benefits provided to date – more than $32 million – are for cancer drugs and another nearly 10% – about $16 million – are for drugs provide to multiple sclerosis patients. 

Last year, Medicare provided immediate relief to seniors with high drug costs in the form of a one-time $250 rebate check for every person who fell into the donut hole.  Nearly 4 million seniors received checks to help defray the costs of prescription drugs.  This year that assistance has been expanded, and by the end of the decade – thanks to the health care law – the donut hole will be closed.

This is only part of the help people with Medicare are getting this year.  Since January 1, people with Medicare may receive for an annual Wellness Visit with their doctor to make a plan to keep healthy  Also, all those with Medicare can receive recommended preventive care, including certain cancer screenings, for free.  All of these improvements to Medicare will help Americans with Medicare live longer, healthier lives.  That’s the kind of good news we can all celebrate.

Visit this page to see how many people with Medicare have received discounts on their prescription drugs in your State – and the average and total discount amounts by State.

Win the Connecting Generations Challenge

Older Americans Month is an occasion to show appreciation and support for our seniors as they continue to enrich and strengthen our communities.

This year’s theme—Older Americans: Connecting the Community—pays homage to the many ways in which older adults bring inspiration and continuity to the fabric of our communities, and highlights how technology is helping older Americans live longer, healthier, and more engaged lives.
The U.S. Administration on Aging is sponsoring two exciting activities in observance of Older Americans Month 2011, a video challenge and a video game tournament. We welcome and encourage the participation of seniors and community members across the country.

For more information about Older Americans Month, visit the U.S. Administration on Aging.

Paying Hospitals for Quality Care

By Don Berwick, Administrator, Centers for Medicare & Medicaid Services. Crosspost from Healthcare.gov

America has a skilled health care workforce and great hospitals. Every day, our health professionals are committed to improving care processes and systems for patients. Health care professionals have been encouraging Medicare to update payment procedures for a long time; validating the quality of care they provide to patients over the quantity. By improving transparency, we are envisioning a health system where all Americans get the best possible care. So how will your doctor, your hospital, and Medicare align to fight disease and provide you with the best possible care?

Today, the Department of Health and Human Services (HHS) announced the Hospital Value-Based Purchasing Program, created under the Affordable Care Act. This program provides hospitals with incentive payments based on their performance on a number of health care quality measures. These quality measures include:

•How quickly do heart attack patients receive potentially life-saving surgery?
•How often do patients with heart failure get the discharge instructions they need to help them care for themselves?
•How satisfied are patients with their experience of care at the hospital?

This is an important national initiative that will give hospitals greater financial incentives to continually improve how they deliver care. The better a hospital does on its quality measures, the greater the incentive payment it will receive from Medicare under the initiative. This will help improve the odds that every patient receives the best care, regardless of the location of treatment. It also encourages “patient-centered” care. The Hospital Value-Based Purchasing Program captures information about patient satisfaction with their care. It asks the important questions about how well hospital staff communicated with patients during and after a hospitalization and the overall cleanliness of the hospital environment.

As the largest payer for hospital services, Medicare is in a special position to reward hospitals for looking for ways to improve how a patient experiences an inpatient stay. The new program encourages hospitals to adopt practices that have been shown to be effective in improving patient outcomes. Equally important, it will be looking very carefully at whether the patient feels that he or she has been treated with respect and compassion, and has been given the opportunity to participate in decisions about treatment.

Are you wondering how your local hospital measures up? Well, you can head to www.HealthCare.gov/compare/ to find the Hospital Compare Care Quality tool to find out how hospitals across the country are doing on 44 different care quality measures.

The Hospital Value-Based Purchasing Program is just one part of a broad-ranging effort by the Obama Administration to improve the quality of health care for all Americans, using important new tools provided by the Affordable Care Act – including the Partnership for Patients.

Through this program, Medicare is helping to improve patient safety and quality of care. The time has come for all of us to be on the same page and distinguish adequate care from excellent care. This payment plan places the patient at the center of care. Hospitals are now paid for how well they provide care, and more importantly, how well the patient does under their care. Together with our vigilant healthcare work force, hospitals will be able to continue to find ways to provide even more excellent care to every one of their patients.

To learn more about Hospital Value-based Purchasing, please visit this page.