Magazine article Drug Topics

Medicare, Medicaid Patients Need Special Rx Care

Magazine article Drug Topics

Medicare, Medicaid Patients Need Special Rx Care

Article excerpt

As more and more Medicaid and Medicare patients join health maintenance organizations that provide them with a managed pharmacy benefit for the first time, these organizations must make sure these patients receive high-quality pharmacy services.

That was the message from Allan Zimmerman, president, Prudential Pharmacy Management, Roseland, N.J., as he spoke at the Academy of Managed Care's conference on Medicare and Medicaid, held at the end of January in Baltimore. Zimmerman is AMCP president.

On the Medicare side, he noted, HMOs are signing up senior citizens at a rate of 70,000 enrollments per month. Many of these HMOs promise the seniors a pharmacy benefit they have not had before under Medicare, which does not pay for outpatient medications. HMOs must be especially careful, therefore, in how they manage the new benefit-placing it under constant review.

Continuity of care is needed so that Medicaid and Medicare patients can achieve good patient outcomes, he observed. This is especially a problem when patients enroll in an HMO and then switch to another organization soon after. Senior citizens who use many medications can easily wind up on duplicate prescriptions because no one provider is overseeing their total drug regimen. …

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