Medicare Part D in Its Ninth Year: The 2014 Marketplace and Key Trends, 2006-2014

This report presents an analysis of the Medicare Part D 2014 marketplace, prepared by Jack Hoadley and Laura Summer (Health Policy Institute, Georgetown University), Elizabeth Hargrave (NORC at the University of Chicago), and Juliette Cubanski and Tricia Neuman (Kaiser Family Foundation).Data on plan availability and premiums were collected primarily from a set of files published by CMS on a regular basis:

• 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.
• Plan premium files, also 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.
• Plan crosswalk files, also 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.
• Enrollment files, released on a monthly basis. These files include total enrollment by plan. We use February 2014 enrollments for enrollment-based analysis in this report (April 2014 for tables involving plan-level enrollment information for LIS enrollees, the only month for which LIS plan enrollment is available). Enrollment files suppress totals for plans with 10 or fewer enrollees. We impute a value of 5 enrollees for these plans.
• LIS enrollment files, released each spring. These files include total enrollment counts for LIS enrollees.
• Plan finder files, released each fall. These files, which supply information for the Plan Finder, contain cost-sharing amounts at the tier level, as well as tier labels.

Results on plan benefits and formularies were supplemented with results from analysis funded by the Medicare Payment Advisory Commission (MedPAC) and performed by Elizabeth Hargrave and Katie Merrell (Social & Scientific Systems, Inc.). This analysis used plan benefit and formulary files released by CMS, in addition to the plan landscape and enrollment files. An important element of this analysis is that a drug is defined as a unique chemical entity. Thus, a plan is counted as listing a drug on its formulary if it lists any brand or generic version or any form or strength of the chemical entity. Portions of this analysis are published in MedPAC’s annual reports to Congress and databooks. We appreciate the cooperation of Katie Merrell and the MedPAC staff in making information available for this report.