Tuesday, October 5, 2010

Kaiser Predicts 10% Increase in Part D Premiums; Berwick Comments on Transparency

The Kaiser Family Foundation is out with a new report analyzing data released by the Centers for Medicare and Medicaid Services (CMS) last month regarding Medicare Part D plans for 2011.  The most noteworthy finding comes on the report’s first page:

The average monthly PDP premium will be $40.72 in 2011 (weighted by 2010 enrollment, assuming beneficiaries remain in their current plan).  This is a 10 percent increase ($3.82) from the weighted average monthly premium of $36.90 in 2010, and a 57 percent increase from $25.93 in 2006, the first year of the Medicare Part D drug benefit.  CMS reported a $1 increase in the average premium for standard Part D coverage between 2010 and 2011; the higher increase reported here incorporates higher premiums for enhanced coverage offered by nearly half of all PDPs and excludes premiums for Medicare Advantage drug plans.

These results are consistent with a study released two weeks ago by Avalere Health, which projected that the largest Part D plans would see premium increases averaging 10 percent.  They’re also consistent with an earlier analysis by the Congressional Budget Office, which found that closing the Part D prescription drug “doughnut hole” would raise premiums – because seniors would have stronger financial incentives to remain on costlier, brand-name drugs rather than switching to generics.  As a result, while premiums rose by less than $2 per month in 2010, the Kaiser report predicts a doubling of the increase in the coming year, to nearly $4 per month.  In other words, most seniors will pay higher premiums, so that only some seniors reaching the prescription drug “doughnut hole” will benefit.

Separately, CMS Administrator Donald Berwick made his first appearance on Capitol Hill yesterday – at a forum that came four days after Congress adjourned for the elections.  What’s most noteworthy from a BNA report on his speech were his thoughts on transparency: “This is a time for a certain amount of courage about information in American health care, a time in which, I think, we all take the risk of openness and disclosure and transparency because deep down we are ready to believe that from that sharing will emerge learning.”  Given his comments, it’s worth examining Dr. Berwick’s own transparency record in government.  Since his controversial recess appointment in early July, Dr. Berwick:

  • “Exited behind a stage” at a July press event on health IT regulations before the media were allowed to ask questions, according to Inside Health Policy;
  • Declined to participate in an August conference call with reporters to discuss a report on Medicare’s solvency;
  • Declined to participate in the release of the annual Medicare trustees report;
  • Declined to respond to interview requests from both the New York Times and Congressional Quarterly;
  • Declined to remain on an August conference call “to take questions from reporters,” according to The Hill;
  • “Left without taking questions from reporters” after delivering a speech to health insurance executives and lobbyists;
  • Declined to answer a series of questions from a reporter about his prior writings on rationing; an Administration official accompanying Dr. Berwick responded solely that “He’s not taking any questions.”

Some may argue that these actions are hardly consistent with Dr. Berwick’s statement yesterday that “the risks of transparency are worth taking” when it comes to improving health care.