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Resources by Topic: Pharmacy and prescription drugs

Calendar Year (CY) 2025 Medicare Physician Fee Schedule Final Rule
Fact sheet providing an overview of the Centers for Medicare & Medicaid Services (CMS) final rule regarding updates and changes to the Medicare payments under the Physician Fee Schedule (PFS) and other Medicare Part B issues for calendar year 2025. Summarizes provisions related to telehealth services; advanced primary care management services; behavioral health services; opioid treatment programs; dental and oral health services; Rural Health Clinic (RHC) and Federally Qualified Health Center (FQHC) care coordination services, telecommunication services, intensive outpatient program (IOP) services, and payment for vaccine costs; and more.
Date: 11/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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2024 Rural-Urban Disparities in Health Care in Medicare
Examines rural/urban differences in the quality of healthcare received by Medicare beneficiaries in 2023, with breakdowns by race and ethnicity. Describes trends in quality of care for rural and urban residents between 2017 and 2023.
Date: 11/2024
Type: Document
Sponsoring organizations: Centers for Medicare and Medicaid Services, RAND Corporation
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Community Responses and Adaptations Following the Closure of a Rural Pharmacy and Primary Care Facility
Uses interviews with 26 community members to identify the impact of a pharmacy and primary healthcare facility closure in a rural Pennsylvania community. Discusses challenges for vulnerable populations, distance to care, social networks, delayed treatment, emergency medical services, alternative medicine, and more.
Author(s): Hazel Velasco Palacios, Kristina Brant, Danielle Rhubart, Jorden Jackson
Citation: Journal of Rural Health, 2024
Date: 11/2024
Type: Document
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Separate Payment for Essential Medicines – New Biweekly Interim Payments for the Inpatient Prospective Payment System
Provides an overview of payment adjustments to small, independent hospitals for establishing and maintaining access to buffer stocks of essential medicines for cost report periods beginning on or after October 1, 2024.
Date: 10/2024
Type: Document
Sponsoring organization: Centers for Medicare and Medicaid Services
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Beneficiary and Clinician Perspectives on Medicare and Other Issues: Findings from 2024 Focus Groups in Select States
Summarizes findings from 24 focus groups of Medicare beneficiaries, Medicare and Medicaid (dual eligible) beneficiaries, and clinicians conducted between May and June 2024, including three virtual focus groups of rural Medicare beneficiaries. Highlights themes that emerged across the focus groups covering Medicare coverage options, access to care, telehealth, organization of care, and prescription drugs.
Date: 10/2024
Type: Document
Sponsoring organizations: Medicare Payment Advisory Commission, NORC at the University of Chicago
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As Pandemic-Era Policies End, Medicaid Programs Focus on Enrollee Access and Reducing Health Disparities Amid Future Uncertainties: Results from an Annual Medicaid Budget Survey for State Fiscal Years 2024 and 2025
Examines changes taking place in Medicaid programs in the 50 states and the District of Columbia. Features sections on delivery systems, provider rates and taxes, benefits, and pharmacy and prescription drugs. Highlights challenges and priorities related to state workforce shortages, systems issues, emerging state budget pressures, and more.
Author(s): Elizabeth Hinton, Elizabeth Williams, Jada Raphael, et al.
Date: 10/2024
Type: Document
Sponsoring organization: KFF
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Medicare Part D Enrollees Reaching the Out-of-Pocket Limit by June 2024
Examines the number of Medicare Part D enrollees who reached the catastrophic Inflation Reduction Act (IRA) out-of-pocket prescription drug spending cap by June 2024. Provides demographic information on enrollees who reach the catastrophic phase and the related savings, including breakdowns for state and metropolitan, micropolitan, or rural/unknown location.
Author(s): Kenneth Finegold, Kristen L. King, Bisma A. Sayed, Rachael Zuckerman
Date: 10/2024
Type: Document
Sponsoring organization: HHS Office of the Assistant Secretary for Planning and Evaluation
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Rural–Urban Differences in Dental Opioid Prescribing among Adolescent/Young Adult and Adult Medicaid Beneficiaries
Examines dental opioid prescription rates for adolescents and adults in rural and urban communities, utilizing 2021 Transformed Medicaid Statistical Information System Analytic Files data. Breaks down data by race and ethnicity, neighborhood disadvantage, and other demographic factors. Includes color-coded maps showing ranges of prescribing rates in rural and urban areas by state.
Author(s): Carla Shoff, Alex Sheen, Luping Qu, Natalia I. Chalmers
Citation: Frontiers in Public Health, 12
Date: 10/2024
Type: Document
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Medicare Payment Basics: Part D Payment System
Overview of the Medicare Part D prescription drug benefit, including subsidy amounts, payments to plans, how enrollee premiums are calculated, and benefit and payment updates.
Date: 10/2024
Type: Document
Sponsoring organization: Medicare Payment Advisory Commission
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Disparities in the Real-World Prescription Pattern of Oral Anticoagulants for US Medicare Beneficiaries: A Geospatial Analysis
Analyzes geographic variations in oral anticoagulant prescribing, utilizing 2020 Medicare Provider Utilization and Payment data. Compares rural and urban clinicians' likelihood of prescribing warfarin only, direct oral anticoagulants (DOACs) only, or both warfarin and DOACs, and highlights regional prescribing patterns using color-coded, county-level maps.
Author(s): Jingrui Zou, Dong Liang, Yong Zhu
Citation: BMJ Open, 14, e081628
Date: 09/2024
Type: Document
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