The number of medications prescribed to treat long-term chronic conditions is rapidly increasing in the United States. Though the exact figures are staggered across various studies and research, the universal concept is a significant increase in polypharmacy and medications prescribed per person. A study by Merck Pharmaceuticals suggests nearly 40% of geriatric populations regularly take at least 5 different prescription medications. With this rapid increase in prescribing and dispensing it is important to consider the standard of care and how healthcare standards are improving over time. Many of the differing standards of care come from a patient’s coverage and how they are paying for their healthcare services. A cohort investigational study was conducted regarding the usage of high-risk medications (HRMs) in older adults (minimum 66 years) with Medicare advantage plans as opposed to traditional Medicare enrollment.


The study was done to determine if there was a significant difference in the usage of HRMs in patients with either plan. The study was done in part to bring attention to gaps in health equity and determining the extent of differences in healthcare for various coverages. Limiting the usage of HRMs in older adults and geriatric population is a nationwide concern, and providers and pharmacists should encourage high quality of care for these populations. Reducing HRM usage will improve patient care, reduce health care burden and prevent adverse drug events. The studies show that there was an association between lower rates of HRMs filled and older adults with Medicare Advantage Plans. Some reasons for this difference may be more aggressive management strategies, higher quality measures and higher risk-reduction incentives in advantage plans. For example, though both Medicare plans are monitored has been monitored using quality measures from the Healthcare Effectiveness Data and Information Set (HEDIS); Medicare advantage plans specifically are mandated to report their HRM rates under strict measures and guidelines.


Fortunately, despite the increase in prescribed medications, the overall prescribed HRMs received by these populations has consistently been decreasing over the past few years regardless of their coverage. Figures suggest that HRM prescription rates in Medicare advantage plan beneficiaries were consistently lower than traditional fee-per-service plans, but fortunately that gap has been decreasing over the past 6 years of research compiled for the study. These figures show an improvement for standardized quality of care and closing the gaps in health equity, but also suggests that there is still much work to be done to achieve the overarching healthcare goals.

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