The Policy Process, Part II University of Phoenix HCS 455 The Policy Process, Part II In the paper the author discussed The Policy Process, Part I on how Medicare part D became a policy. The author discussed the details on the formulation, legislative, and implementation stages of the policy. Now time to look at the final stages of the process, of Medicare Part D. Which are evaluation, analysis, revision, and methodology stages. In every policy there will be an evaluation stage to see how the policy will work and what needs to be done to evaluate the process. Evaluation Stage
The evaluation stage is a process in which policymakers in the Senate and House look at a policy and evaluate the future outcomes of a policy in this case Medicare Part D. For instance once of the evaluation process would be how policymakers would evaluate the pharmaceutical companies to make sure to keep prescription costs down. Another would be to evaluate how many senior citizens are enrolling in the plan. As well as making sure senior citizens have all the information available to them to choose the correct plan that fits their prescription needs. For instance the Kaiser Foundation did a study on the technical problems of Medicare Part D.
One of Kaiser’s findings seen confusion on which prescriptions would be covered from the numerous plans that an individual can choose from. As well, as medical providers not getting the new medical software to transition Medicare Part D into their computer systems. This meant that difference agencies like, doctors, insurance companies, and pharmacies run different programs and that have different policies on how to share patient’s information. Now on the other hand, if all these agencies can have the same software this would allow everyone in the patient’s medical circle to share the same codes and computer language.
Thus, not having to have a great deal of public pain and confusion about the patient’s drug coverage’s. Another problem was transferring large patient’s files from one insurer to another insurer can take up to six months, from a 2004 study from the Medicare Payment Advisory Commission(Terri Emerick, 2006). One of the solutions to these problems would be to evaluate the information which is being sent to senior citizens. Medicare should send out their booklet to all senior citizens that are in the drug plan. All senior citizens should write down their medications which they are taking.
Many seniors that do go to their local senior centers should go online and check out the Medicare website for information. As well calling Medicare to ask questions about which plan will work best for them. Do not forget to talk to your local pharmacist he or she might be able to tell the names of the plans which cover the prescriptions. By evaluating these areas policymakers can get information from outside agencies to do research and come up with results from polls, interviews, and surveys. In evaluating all this information policymakers can form an analysis of Medicare Part D and see what need to be done.
Analysis Stage Analyzing Medicare Part D as the author stated earlier one of the problems where the technical problems between the different agencies and sharing patients information. On February 17, 2009 President Obama signed a $787 billion dollar stimulus bill which puts $150 billion dollars on spending health information technology (Omini MD, 2009). This new plan physicians and health professionals will now receive incentives for implementing IT programs into their computer systems. Becoming paperless will maximize Medicare as well as physicians and medical professionals.
By 2015 it will be mandatory that all physicians and medical professionals use IT programs. The United States Department of Health and Human Services (HHS) by December 31, 2009 under the stimulus act will develop a set of standards, implementation methods, and criteria for the new IT system to be in place (Chris Silvia, 2009). Another analysis was made about the enrollment period. The enrollment period to enroll in a drug coverage plan is from November 15th through December 31st. Many elderly individuals felt they were getting rushed into signing up for a plan.
Most of them were confused and explaining why they must pick a new drug coverage program every year. Many individuals fail to sign up within the six week time frame due to their medical or mental condition. This is something that would need to be analyzed and see if they can extend the enrollment period from six week to 12 weeks. Start the enrollment period on October 1st instead of November 15th. This would give many elderly individuals plenty enough time to pick, choose, and switch plans before the December 31st end date.
In this entire analysis one must think there should be revisions made to the policy to make it better. Revision Stage In revising a policy starts by looking to see which policies need to be updated or changed to make the policy better. On September 5, 2008 one of the revisions in Medicare Part D was the use of Electronic Prescription Program (E-prescribing) Centers for Medicare and Medicaid Services (CMS) expects that Medicare Part D sponsors will have all the necessary contracts and systems in place should prescribers desire to use E-prescribing (Claudia Schlosberg, n. . ) As stated in the paragraph above with IT systems for physicians and health professionals using paperless system will maximize Medicare. This revision will not only help out pharmacies but help out physicians. Now this information will allows doctors to find out what prescriptions the patient has used in the past and where the patient usually goes to pick up his or her medications from. By revising this policy everyone in the medical community can deliver faster and better care for the individual.
Since many senior citizens continue to do work, due to their low income, CMS has revised a section on Medicare Part D for employers. Employers whom are offering medication drug coverage’s to Medicare individuals will now disclose to CMS if the plans the employer is offering are creditable. To make sure that the prescription drug plans are creditable, the plans must equal or exceed the actuarial value of defined standard prescription drug coverage under CMS guidelines (Kutak Rock, 2007).
This revision in Medicare Part D is very important for seniors, this way seniors can know if the program that they have from work is creditable and make a decision on whether or not he or she should waive the enrollment of Medicare Part D. They employer must submit to CMS all the prescription drug plans that they offer to see if the plans follow CMS guidelines. Employers must also send out information to those individuals in the plan on or before the Medicare Part D enrollment date of November 15th of each year. Purpose and Methodologies
One of the methodologies in Medicare Part D was to make sure senior citizens get help with their drug prescription costs. Even thou CMS has many plans to choose from seniors need to do their part in researching some of the plans via internet, CMS hotline, and talking to their pharmacist. In turn the E-prescribing was another to help physicians and pharmacies to collect information more quickly without using any paper. By having everything computerized pharmacists can receive and gather information quickly compared to the old practice of using a fax machine.
Using a computer eliminates misplaced fax paper, paper jams, or the fax did not go through. This saves time and money on both parts for the physician and pharmacists. IT software stimulus package the president Obama signed this year to help all healthcare professions to go paperless and receive patient’s information more quickly than before. This as well will save time and money for healthcare professionals in managing patient’s data to make sure all parties involved get the information they need for billing and medical information.
So these are just some of the purposes and methodologies for some changes in the Medicare Part D. Conclusion As more senior citizens coming into retirement Medicare Part D will be a major focus of discussion on the political front. Both Democrats and Republicans have different ideas on how to evaluate, analyze, and revise Medicare Part D. Of course, from the author’s perspective having IT software programs in place will help out indeed for all healthcare professionals and providers. Now with the Obama stimulus plan sign this year hopefully, all healthcare professions can be on the same track to get these IT systems in place.
The benefits are enormous to getting information faster to the right people, especially in an emergency. Although CMS needs to do a better job on informing seniors about the prescription drug plans, so that way they can make better judgments on the plan they choose. Even better yet cut down on some of these plans these are way too many of them and they are confusing seniors on which plan to choose from. Either way policymakers from both sides need to work with healthcare professional to see what can be done to improve on Medicare Part D. References Chris Silvia (2009).
Practices paperless before 2012 could maximize Medicare bonuses. Retrieved December 2, 2011, from http://www. ama-assn. org/amednews/2009/03/16/gvsa0316. htm Claudia Schlosberg (n. d. ). CMS Revises Medicare Prescription Drug Benefit Manuel-Chapter 7 Medication Therapy Management and Quality Improvement Program. Retrieved December 2, 2011, from http://www. ascp. com/advocacy/upload/ASCP%20Summary%20of %20CMS%20Chap%207%20Revisions. pdf Kutak Rock (2007). Medicare Part D: CMS Revises Model Notice and Disclosure Notice Requirements. Retrieved December 2, 2011, from http://www. utakrock. com/publications/employeebenefits/EBCA1107. pdf Omini MD (2011). Medicaid, health IT to see billions from stimulus package signed by Obama. Retrieved December 2, 2011, from http://www. myemrstimulus. com/tag/emr-software/ Omni MD (n. d. ). Medicaid, health IT to see billions from stimulus package signed by Obama. Retrieved December 2, 2011, from http://www. myemrstimulus. com/tag/emr-software/ Terri Emerick (2006). Part D:Rx for Disaster. Retrieved December 2, 2011, from http://www. epluribusmedia. org/archives/features/2006/0511part_d. html
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