Medicare Part D: An Interview with Healthcare Leadership Council

Medicare Part D: An Interview with Healthcare Leadership Council

09.22.11 | By Kate Connors

Recently, we had the chance to speak with Mary Grealy, president of the Healthcare Leadership Council (HLC), about the Medicare prescription drug benefit. Grealy is also the co-chair of Medicare Today, a program intended to help seniors understand and enroll in Medicare Part D.

Tell us a bit more about HLC.
The Healthcare Leadership Council is unique among health advocacy organizations. Our members are leaders from every sector of American healthcare - insurers, providers, distributors, creators of pharmaceuticals and medical devices, pharmacies. They bring diverse points of view to the table, but they have a unified vision of a healthcare system that is accessible, affordable and defined by high quality and continuous innovation.
Lawmakers find the presence of an organization like HLC very useful. We present an opportunity for "one-stop shopping" to gain viewpoints that reflect the breadth of the healthcare industry.
What is Medicare Today? How long have you been co-chair of the organization?
Medicare Today came into being immediately after the Medicare Part D prescription drug benefit was created by Congress. We knew that a tremendous effort would be required to inform millions of Medicare beneficiaries about the value of this program and instruct them on how to enroll. This was an undertaking of greater magnitude than the government could be expected to handle by itself.
So we pulled together over 400 national and local organizations - everyone from AARP to local senior centers - and built this coalition to let seniors know how Part D would benefit both their health and their pocketbooks. This was the kind of effort that couldn't be done with just a mailer or a TV commercial. You needed that face-to-face communication to help people feel secure about their decision to enroll in the program.
I've been co-chair of Medicare Today since its inception. For much of that time, I've worked with former U.S. Senator John Breaux (D-LA), who was one of Washington's strongest voices in saying Medicare should offer prescription drug coverage.
You have focused a great deal of time and attention on the efficacy of Part D. How has the program evolved over the past five years?
When Part D began, it was surrounded by a good deal of controversy because of the vigorous debate in Congress over its passage and the very close margin of the final votes. Since that time, though, the program has enjoyed strong bipartisan support and, in fact, Medicare Today has worked closely with members of Congress from both parties in providing information to their constituents.
Today, Part D is viewed as part of the fabric of the Medicare program. In a relatively short time, this program has become so widely accepted that I don't think anyone can imagine a Medicare that didn't offer coverage of prescription medications.
What do you hear from seniors who didn't have coverage beforehand? Has the program made a significant impact?
I've gone on the road to several town hall meetings and events at senior centers. So often in Washington, policies are viewed in the abstract. You talk about how a particular program may affect millions of people, but that's just a number. It's not often enough that we get to see with our own eyes the real human impact of a new federal initiative.
But I've seen that when I've talked to seniors about Medicare Part D. I've had the opportunity to sit down with so many men and women who have told me how they used to cut pills in half to make their prescriptions last longer, or how they simply didn't fill what their doctor prescribed. Now, though, they have a program that allows them to protect their health without putting them in financial jeopardy. The joy and relief on their faces is something I will never forget.
What, if anything, do you think should be changed about the program?
The basic concept of the Part D program remains strong and effective. Giving beneficiaries a choice of prescription drug plans is keeping costs affordable, as plans compete for beneficiary loyalties. One of the major changes that Part D needed is already taking place, with the gradual closing of the coverage gap, or the so-called 'donut hole.' Thanks to the provisions in the Affordable Care Act and the financial support of the nation's pharmaceutical companies, beneficiaries with high pharmaceutical needs will get a needed break on their out-of-pocket costs.
We need to continue an intensive effort to reach out to low-income seniors who are eligible for federal subsidies that would pay for all or most of their coverage, but are still not enrolled. The Kaiser Family Foundation estimates that there are approximately 2.3 million beneficiaries who are eligible for this subsidy but, for whatever reason, are not taking advantage of it. We need to keep working to make sure all who need this prescription drug assistance are receiving it.
Mostly, though, I think lawmakers have to take care to do no harm to a program that is working extremely well, offering great value to beneficiaries and achieving astounding popularity ratings. Each year, Medicare Today does a survey of beneficiaries to gauge their views of Part D and, routinely, we find that over 80 percent of seniors have a favorable opinion of the program. We should not alter an approach that is working so well.
With the Medicare enrollment period upon us, what should seniors and other Medicare beneficiaries be focusing on? How long does it run?
This year, the Medicare Part D open enrollment period runs from October 15 through December 7. That's a little different than past years when it has run up until the end of the calendar year, so beneficiaries need to pay close attention to this change.
I always advise beneficiaries to use this period to take a close look at the plan in which they are currently enrolled, as well as the other plans available to them. For many seniors, the Thanksgiving holidays present an excellent opportunity to have family members help them with this comparison shopping. The beauty of the Medicare Part D program is that there are multiple plans available, so beneficiaries can find a plan that covers their particular medications at a reasonable price. And by taking a look at the plan choices, seniors may find one that offers a significant savings advantage over what they currently have. There's no harm in comparing, and beneficiaries should use this open enrollment period to do so.

More On PhRMA — powered by PhRMApedia


Cost in Context