Medicare Part D in 2016 and Trends over Time

This chart collection presents an analysis of the Medicare Part D 2016 marketplace and trends since 2006, prepared by Jack Hoadley, Health Policy Institute, Georgetown University; and Juliette Cubanski and Tricia Neuman, Kaiser Family Foundation. Anthony Damico, an independent consultant, provided data analysis on the average number of Medicare Advantage drug plans per beneficiary.

Data on Part D plan availability, enrollment, and premiums were collected primarily from a set of data files released by the Centers for Medicare & Medicaid Services (CMS) on a regular basis:

• Part D plan landscape files, released each fall prior to the annual enrollment period. These files include basic plan characteristics, such as plan names, premiums, deductibles, gap coverage, and benchmark plan status.
• Part D plan premium files, released each fall. These files include more detail on plan characteristics, including premiums charged to LIS beneficiaries, the portions of the premiums allocated to the basic and enhanced benefits, and the separate drug premiums for MA-PD plans.
• Part D plan crosswalk files, released each fall. These files identify which plans are matched up when a plan sponsor changes its plan offerings from one year to the next.
• Part D enrollment files, released on a monthly basis. These files include total enrollment by plan. We use February 2016 enrollment counts for enrollment-based analysis in this report. Enrollment files suppress totals for plans with 10 or fewer enrollees. We impute a value of five enrollees for these plans.
• Part D Low-Income Subsidy enrollment files, released each spring (in March for 2016). These files include total enrollment counts for LIS enrollees. There are small differences, most likely due to different dates and underlying files, between total enrollment counts in the LIS enrollment files and those in the general enrollment files. As with the other enrollment files, we impute a value of five enrollees for amounts suppressed for plans with 10 or fewer enrollees.
• Medicare plan benefit package files, released each fall. These files supply detailed information on the benefits offered by plans, including cost-sharing amounts for each formulary tier, tier labels, and the different cost-sharing amounts for standard and preferred cost-sharing pharmacies, where applicable.
• Medicare county-level enrollment files, released on a monthly basis. These files are used to create total counts at the state level. Because they are different than the plan-level enrollment files, national totals for these files are not identical to totals in other exhibits. We impute values of one beneficiary for all plan/county combination where values of 10 or fewer beneficiaries are suppressed.

Due to methodological differences, some numbers for MA-PD plans in this analysis differ from those in a May 2016 Kaiser Family Foundation report, Medicare Advantage 2016 Spotlight: Enrollment Market Update. Methodological differences include:

• How Blue Cross Blue Shield (BCBS) affiliates are treated: this analysis treats BCBS-affiliated firms separately; the Medicare Advantage Spotlight combines BCBS-affiliated firms [excluding Anthem).
• How plans in the territories are treated: this analysis does not include data for plans in the territories, including Puerto Rico; the Medicare Advantage Spotlight includes Puerto Rico but excludes other territories.
• Which month is used for enrollment counts: this analysis uses February for Part D enrollment; the Medicare Advantage Spotlight uses March enrollment files.
• How plans with small enrollment counts that are suppressed in CMS files are treated: this analysis imputes a value of five enrollees for total enrollment in such plans; the Medicare Advantage Spotlight excludes plans with small enrollment counts in estimates that are plan-enrollment weighted.