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Center for Health Services and Outcomes Research

Patient Outcomes – Patient Reported

SMI Dual Eligibles and Medicare Part D: Impact on Medications Continuity and Outcomes

The study examines the impact of Medicare Part D on changes in medications, medications continuity, utilization, and cost over a period of 5 years. The study population is Maryland residents aged 18 to 60 who were severely mentally ill (SMI) and who were dually eligible for Medicare and Medicaid in the year before Part D was initiated. A matched comparison group consists of persons with SMI who receive only Medicaid benefits and are thus ineligible for Part D.  The pharmacy benefit plans available to Part D enrollees are characterized with regard to provisions such as formulary structure, stepped therapy requirements, copayment levels, quantity limits, and prior authorization requirements.  Outcomes being examined include mental health hospital admissions and crisis care, mortality, and costs of care as well as medications changes and continuity.