Navigating Medicare Part D Websites: Are the Part D Plans in Compliance?

Today, more than one half of older adults use the internet to obtain health-related information, and there is growing interest from governmental agencies in providing information online. The Centers for Medicare & Medicaid Services (CMS) provides guidance to Part D prescription drug plan sponsors about information to include on their websites. The current article examines compliance with the 2014 CMS guidance for Medication Therapy Management (MTM) program information on Part D plan sponsors' websites. There were 59.5% of plan sponsors that had a dedicated MTM program webpage, accessible within two clicks from the plan sponsor's home page and provided basic information, eligibility for MTM services, and access to a blank copy of a personalized medication list document. Although improvements in the provision of information about plan sponsors' MTM programs can be made, future work should evaluate the usability and effectiveness of the online MTM program information provided to Medicare beneficiaries. [Journal of Gerontological Nursing, 42(10), 9-14.].

Disparities in access to health care among middle-aged and older adults with disabilities.

Disability is increasing among middle-aged adults and, reversing earlier trends, increasing among older adults as well. Disability is experienced disproportionately by Black and lower socioeconomic status (SES) individuals. We used Medical Expenditure Panel Survey data to examine health care disparities in access to health care for middle-aged (31 to 64 years of age) and older (65+ years of age) adults with disabilities by race and ethnicity, education, and income (n=13,174). Using logistic regression, we examined three measures of potential (e.g., usual source of care), and three measures of realized (e.g., counseling related to smoking) access. Middle-aged and older minority individuals with disabilities had lower relative risks of having usual sources of care and higher relative risks of having suboptimal usual sources of care (e.g., a place rather than a person) than White adults with disabilities. There were SES effects observed for middle-aged adults with disabilities across most measures that were, for certain measures, more pronounced than SES effects among older adults with disabilities. These findings are important, since health resources (e.g., a usual source of care) may mediate relations among disability, morbidity, and mortality. Policy actions that may mitigate the disparities we observed include financial incentives to support access to an optimal usual source of care and mechanisms to foster behavioral interventions related to smoking and exercise. Ensuring that these actions address the specific concerns of individuals with disabilities, such as physical accessibility and provider cultural competency, is essential.

The relation between health insurance and health care disparities among adults with disabilities.

OBJECTIVES: We examined disparities among US adults with disabilities and the degree to which health insurance attenuates disparities by race, ethnicity, and socioeconomic status (SES). METHODS: We pooled data from the 2001-2007 Medical Expenditure Panel Survey on individuals with disabilities aged 18 to 64 years. We modeled measures of access and use as functions of predisposing, enabling, need, and contextual factors. We then included health insurance and examined the extent to which it reduced observed differences by race, ethnicity, and SES. RESULTS: We found evidence of disparities in access and use among adults with disabilities. Adjusting for health insurance reduced these disparities most consistently for emergency department use. Uninsured individuals experienced substantially poorer access across most measures, including reporting a usual source of care and experiencing delays in or being unable to obtain care. CONCLUSIONS: Although health insurance is an important enabling resource among adults with disabilities, its effect on reducing differences by race, ethnicity, and SES on health care access and use was limited. Research exploring the effects of factors such as patient-provider interactions is warranted.