Out-of-pocket drug costs and drug utilization patterns of postmenopausal Medicare beneficiaries with osteoporosis.

Background: The Medicare Part D coverage gap has been associated with lower adherence and drug utilization and higher discontinuation. Because osteoporosis has a relatively high prevalence among Medicare-eligible postmenopausal women, we examined changes in utilization of osteoporosis medications during this coverage gap.

Objectives: The purpose of this study was to investigate changes in out-of-pocket (OOP) drug costs and utilization associated with the Medicare Part D coverage gap among postmenopausal beneficiaries with osteoporosis.

The effects of complications and comorbidities on the quality of preventive diabetes care: a literature review.

Although concurrent conditions such as complications and comorbidities are common in people with diabetes, both are often omitted from studies of the quality of diabetes preventive care. This systematic review of the literature on the quality of diabetes preventive care assesses not only trends in the reporting of and adjusting for complications and comorbidities, but also the limitations of current measures of complications and comorbidities. This review identified 34 studies in which the quality of diabetes preventive care was assessed with process measures and complications or comorbidities were reported.

A pilot test of the effect of guided care on the quality of primary care experiences for multimorbid older adults.

Objective: Improving health care of multimorbid older adults is a critical public health challenge. The objective of this study is to evaluate the effect of a pilot intervention to enhance the quality of primary care experiences for chronically ill older persons (Guided Care).

Design: Nonrandomized prospective clinical trial.

The role of health insurance brokers: providing small employers with a helping hand.

Insurance brokers play an important role in helping small employers find affordable health coverage for their workers and dependents. While there are costs for using brokers, an examination of the role of brokers in 12 nationally representative communities by the Center for Studying Health System Change (HSC) indicated that brokers provide valuable services to small firms, such as obtaining prices for coverage, explaining benefits to employees and problem solving for employers. In some markets, brokers also helped educate employers and employees about state policy initiatives to expand coverage.