The Medicare Payment Advisory Commission (MedPAC) proposed several changes to the Medicare Part D program in a June 2016 report. MedPAC advises Congress on policies related to Medicare and its recommendations could potentially be enacted by Congress. This paper by Milliman’s Katie Holcomb and Julia Friedman discusses the impact that MedPAC’s proposed changes could have on plan sponsors, Part D members, and pharmaceutical manufacturers.
In this research report, Milliman’s Brett Swanson, Ari Kramer, and Julia Friedman highlight key changes in beneficiary premiums and benefits for the 2016 Medicare Advantage (MA) market as well as the reasons for and the magnitude of the decrease of value-add within the MA market between 2013 and 2016, with a more detailed look at changes between 2015 and 2016. It also summarizes the components of the Patient Protection and Affordable Care Act (ACA) and subsequent legislated actions driving the downward payments to Medicare Advantage organizations (MAOs). This report also aims to assist MAOs in making strategic decisions during 2017 bid preparations.