Taking on Medicare Part D risk: Provider perspective
12 April 2019
The Centers for Medicare and Medicaid Services (CMS) recently issued a request for comments on the potential use of risk-based arrangements for pharmacy benefits in contracts between Medicare Advantage (MA) plans and contracted providers. CMS noted that risk-based arrangements in contracting for pharmacy benefits may be another tool to drive down the cost of Part B drugs in MA and Part D drugs for MA and Part D plans. This article summarizes the key issues providers need to consider before taking on Part D risk and highlights some of the complexities and common barriers observed when advising provider clients on their strategies for Part D risk.
About the Author(s)
Taking on Medicare Part D risk: Provider perspective
This article summarizes the key issues providers need to consider before taking on Part D risk, an increasingly common ask from Medicare Advantage organizations, and highlights some of the complexities and common barriers observed when advising provider clients on their strategies for Part D risk.
Michael Hunter, Emma Kramer, Simon Moody