Short Takes On News & Events

Hospital Visits Fell When Seniors Got Drug Coverage

By Jay Hancock

April 16th, 2014, 2:58 PM

Eleven years ago Bob Bennett, then a Republican senator from Utah, made a fiscal sales pitch for including prescription drugs in Medicare coverage for seniors.

“Medicare says if you go to the hospital and run up a bill of however many tens of thousands of dollars to stay that many days, we will pay for it,” he said in June 2003. “But if you take the pill that makes the hospital visit unnecessary, we will not. That clearly doesn’t make sense.”

Researchers at the University of Illinois and the Johns Hopkins University have made the broadest test yet of Medicare Part D prescription drug program’s promise — that covering drugs would keep seniors out of the hospital.

Comparing national records from before and after 2006, when Part D kicked in, they found that drug coverage was associated with an 8 percent drop in hospital admissions and nearly as much in hospital-cost savings — an amount they calculate to be $1.5 billion a year.

But here’s what they didn’t find: any difference in death rates between the seniors who had access to drugs under Part D and those who didn’t. They thought broader drug coverage might reduce mortality.

“It’s somewhat surprising that we didn’t see a mortality effect, given that we did see decreases in hospitalization,” co-author Robert Kaestner, an economist at the University of Illinois at Chicago, said in an interview.

But the researchers looked only at deaths at the time. Perhaps drug coverage has a cumulative effect that wouldn’t show up in mortality statistics until later, he said.

For some conditions, the fall in admissions that came with Part D coverage was striking: down 20 percent for dehydration; down 32 percent for chronic obstructive pulmonary disease; down 18 percent for congestive heart failure; down 13 percent for coronary atherosclerosis.

Previous research has also shown that better drug coverage is associated with lower hospital admissions. But the samples were smaller. Or the studies looked at changes in existing drug plans, not the difference between no coverage and full coverage, Kaestner said.

Part D’s cost to taxpayers still far exceeds the savings it generates in fewer hospital visits. But the $1.5 billion in annual hospital savings associated with Part D coverage effectively reduces the expense of that particular program by 2.2 percent, said Kaestner.

In 2012, relying on previous research, the nonpartisan scorekeepers at the Congressional Budget Office said they would begin estimating this kind of savings as part of their total spending projections.

13 Responses to “Hospital Visits Fell When Seniors Got Drug Coverage”

  1. Dora says:

    Hey Jay,
    I am not surprised by the findings this study. You will have a problem when interventions are mainly done to cut costs. As a clinician, i am for the debate that if we send nurses to senior places of residence and teach them about their disease conditions and what to do to stay health, we might have better outcomes. I think sometimes we have given too much power to doctors. Before accepting to take a certain pill to fix a problem i have, how about understanding the long term implications and side effects. What about advocating for therapies or alternative medicine that seem to help. What about challenging patients for lifestyle changes in attempts to stay healthy? I think such measures would help a great deal.

  2. evan says:

    This article is a no-brainer. Alas, we all seem to forget that Republicans, as a political party, have no brains and have yet to understand that a healthy population is a productive population with less chronic conditions. The little bit we spend as a society to subsidize the cost of keeping people healthy comes back to us many times over in savings by not needing to treat the outrageously chronic conditions when left untreated. Again, trying to get Republicans to understand this concept is virtually impossible. If you don’t believe me, just listen to Congressman Paul Ryan for ten minutes and you well see how insane these Neanderthals think. Not to mention penchant they have in seeing our first black President fail at everything he does regardless of the issue. If you vote for a Republican, you vote to go backwards.

  3. Marty says:

    Evan has it all figured out; get rid of the Republican party and everything will sunshine and roses. Heavy sarcasm intended!

  4. Allen R. Nissenson, MD says:

    DaVita HealthCare Partners has been offering a specialty pharmacy program for dialysis patients, with over 60,000 DaVita patients now enrolled. We have shown that patients enrolled in this program are more adherent with their medications than patients who are not enrolled. Most importantly, enrolled patients had a 21% lower likelihood of death and spent 14% fewer days in the hospital compared to patients using other pharmacies (using a propensity matching statistical approach). Ensuring patients receive their prescribed medications, and providing medication management counseling, does matter, particularly for the complex, chronically ill.

  5. Killroy71 says:

    this good news comes too late, alas, for Bob Bennett — Utah teapartiers gave him the boot. And he was a conservative Republican.

  6. Justin says:

    Hey Evan, Medicare Part D (i.e, the Rx benefit) was enacted in 2003–”unpaid for,” no less. Now let’s see–who was running the show a decade or so ago when Part D was passed by Congress and enacted into law? Ah yes, how quickly we forget–it was “Dubya,” Speaker Hastert, and Leader Frist. So, take your shallow gibberish about GOPers being “Neanderthals,” going “backwards,” blah, blah, blah–back on over to Daily Kos or whatever political blog you rolled off of.

  7. Tuan says:

    There has been significant changes over the past decade in regards to health care accountability and pressures to reduce costs and unnecessary hospitalizations with an overall trend towards reduced hospitalizations, including the profound effect of the recession on reduced health care expenditures. Concluding reduced hospitalizations is from Medicare Part D coverage is rather biased, scientifically flawed as cause and effect, and merely supports Big Pharma. Health care is never that simple. If all of these postive conclusions are accurate, why does health care spending and growth remain unsustainable and will one day bankrupct our country? The devil is in the details, having no difference in mortality yet reductions in hospitalizations when hospitalizations increases the risk for death. The analysis is flawed.

  8. Kevin says:

    Evan makes sense! Republicans are still voting to repeal the ACA while, just today, it was announced that 8 million Americans have enrolled in the ACA and 35 percent of those enrollees are under 35 years of age. Duh! Meanwhile, Dimwit Republicans in Congress are getting ready to hold another repeal vote. Neanderthals? That’s being kind! For sure, the GOP is the party of stupid! Meanwhile, America needs jobs! The best we can hope for is for the GOP to vote another 50 times to repeal the ACA, all they way up to the 2014 general election. Please! Keep voting to repeal! Please!

  9. Gene says:

    Really Evan and Kevin! You two call the GOP dumb? Do you expect anyone to take you seriously? Do you really believe that everyone has to think as you do?

  10. “Part D’s cost to taxpayers still far exceeds the savings it generates in fewer hospital visits.”
    I wonder if the fact that the Part D law forbids negotiation with drug companies for a better price, as the VA does, would have something to do with that. When I was in Europe, the health practitioners were laughing at us – they can get our drugs directly from our companies for 1/3 the price we pay in the U.S. – and that’s AFTER their shipped overseas.

  11. Drew says:

    Hey Gene,

    Here’s a news flash! I think like Evan and Kevin. The GOP is dumb like a bag of hammers! Got it?

  12. steven says:

    Hey Justin, Evan is right on target. However, so are you when it comes to DICK Cheney as our de facto President and Dubya as his stupid personal hand puppet. With DICK, we got lots of stuff put on the credit card. With DICK, we got two unfunded tax cuts for the wealthy (2001 & 2003), we got an unfunded decade long Afghan war, we got an unfunded decade long Iraq war and we got an unfunded Medicare Part D. DICK put all these things on America’s credit card. Remember that? Huh? Most Republicans don’t like to remember all those unfunded items. Well, at least the Obamacare is funded. At least Congress figured out how Obamacare would get paid for. Unlike Republicans that claim to be fiscal conservatives, Democrats in Congress at least try to pay for their ideas. The only thing that wasn’t paid for under Obama was the huge Wall Street bailout and the huge economic stimulus of 2009. Fiscally conservative Republicans created those two deficit problems and then dumped them on President Obama when he walked into the Oval Office. Remember that? Huh?

  13. steven says:

    Senior citizens need to get real and face the facts. If Republicans could take away your Medicare, they would! If Republicans could take away your Social Security, they would! The only thing stopping them are Democrats. If you are a senior and you vote for a Republican, you are a total idiot! Voting for Republicans means voting to end Medicare and Social Security. Don’t believe me? Then take a look at Congressman Paul Ryan’s budget plan. It’s a senior citizen’s worst nightmare!