Pharmacist Counseling Improved Understanding of Medicare Benefits

Among underserved populations, researchers Adriane N Irwin, MS, PharmD, and Elisabeth H Manning, BS, both from Oregon State University College of Pharmacy, found that a pharmacist-provided counseling service helped improve patient understanding of Medicare benefits and enabled better insurance plan selections.

“Seniors often report feeling overwhelmed and unqualified to assess their individual health care needs and identify a plan(s) best tailored to their specific situation,” wrote Dr Irwin and Ms Manning. “Resources are available to assist in the decision process, such as the Medicare Plan Finder website managed by the U.S. Centers for Medicare and Medicare Services and state-specific plan guides but accessing these resources can be challenging.”

The study authors sought to understand how the use of a pharmacist-delivered Medicare counseling service in a rural community health center would impact patients and community members. They hoped to provide members with information and resources in order to facilitate more informed health plan selections.

The researchers observed health center patients as well as community members who met pharmacists for individual Medicare counseling. The counseling appointments took place between July 1, 2015, and June 30, 2018. The appointments covered the following:

• a breakdown of Original Medicare and private plan options for supplemental medical and/or drug coverage;
• a comparison on specific plans; and
• an overview on eligibility for financial assistance programs.  

There was a total of 47 appointments that were completed among 31 unique clients. The majority of the participants were female (58.1%) aged 65 years or older (54.8%). The researchers also noted that the appointments were divided between patients established with the health center (48.4%) and community members (51.6%).

“During appointments, the most common topic was an explanation of medical or drug benefits (85.1%) followed by comparison of specific plans (59.5%) and then screening individuals for Original Medicare or private plan eligibility (57.4%),” Dr Irwin and Ms Manning explained.

It was noted that no significant differences were observed among topics discussed among patients for current versus new Medicare beneficiaries. Additionally, the researcher team explained that patients were less likely to be screened for Original Medicare or private plans eligibility (74.2% vs 25%; P =0.002), 4 financial assistance programs (77.4% vs 37.5%; P=0.011), or have specific plans compared (71.0% vs 37.5%; P =0.034) during their follow-up visits.

“A pharmacist-provided Medicare counseling service in a rural community health center was used by both patients and community members,” they concluded. “This may be an effective strategy to improve beneficiary understanding of Medicare benefits and enable better insurance plan selections in underserved populations.”

Of important note, Dr Irwin and Ms Manning said that more research is needed in order to understand individual-level outcomes and scalability to other settings.

—Julie Gould

Reference:

Irwin AN, Manning EH. Implementation of a pharmacist-delivered Medicare counseling service in a rural community health center [published online February 2020]. J Am Pharm Assoc. (2020), doi: https://doi.org/10.1016/j.japh.2020.02.008