New Avalere Health Analysis Finds PSI Charitable Assistance Reduces Medicare Spending and Increases Patient Access to Care

May 7, 2018 | News and Events

New Avalere Health Analysis Finds PSI Charitable Assistance Reduces Medicare Spending and Increases Patient Access to Care

(Midlothian, VA – May 7, 2018) Patient Services, Inc. (PSI), the nation’s first non-profit patient assistance program, today announced a new report from Avalere Health which found that PSI’s charitable assistance reduces patient out-of-pocket costs for medication, improves medication adherence, and lowers total Medicare costs through reduced medical spending. As part of its report, “Patient Out-of-Pocket Assistance in Medicare Part D: Direct and Indirect Healthcare Savings,” Avalere used its proprietary Part D financial model and PSI-provided data and found that PSI assistance reduced spending in Medicare, generated $33.9 million in net federal Medicare savings in 2017, and nearly $146 million in Medicare savings from 2013 to 2017.

“Individuals living with chronic and life-threatening illnesses such as cancer, HIV/AIDS, autoimmune diseases, and other conditions often face prohibitive costs to access the care they need to continue living healthy, productive lives. PSI charitable assistance is a critical lifeline – and often a last resort – that helps thousands of patients and their families effectively manage their conditions,” said PSI Chief Executive Officer Art Wood. “Many Medicare patients are exposed to high out-of-pocket costs for medications and cost-sharing that can lead to significant access and affordability challenges. The Avalere Health report confirms that PSI charitable assistance not only helps these patients access care, but also reduces overall Medicare spending.”

Key findings of the Avalere Health report include:

  • In 2017, PSI helped over 13,500 Medicare Part D patients by providing $70.9 million in cost-sharing assistance. Over the last five years, PSI has provided almost $305 million in assistance to Medicare Part D beneficiaries;
  • Every $1,000 provided by PSI annually to Part D beneficiaries allows those patients to fill an average of 3.5 additional prescriptions;
  • PSI assistance for Medicare Part D medications reduces spending on Medicare Part A and B, which pay for hospitalizations and visits to the doctor, among other services;
  • Avalere estimated that $1 million in PSI assistance reduces spending on Part A and Part B services by $1.83 million. In 2017, this translated to nearly $130 million in total Medicare Part A and Part B savings;
  • Even when accounting for higher Part D drug spending due to increased medication adherence, $1 million in PSI assistance saves the federal government close to $500,0000 across the Medicare program. This means that PSI assistance in 2017 led to $33.9 million in federal savings;
  • Overall, PSI assistance for Part D beneficiaries from 2013 to 2017 saved the federal government almost $146 million;

The Medicare Part D program provides prescription drug coverage to more than 44 million beneficiaries who are elderly or disabled. To help ease the financial burden of health care for patients and their families, PSI provides cost-sharing assistance to patients living with various conditions – including chronic and life-threatening illnesses – that often require expensive drug therapies. Unlike commercial drug coverage offered outside of Medicare, Part D coverage does not cap out-of-pocket expenditures for beneficiaries. This means that many Part D beneficiaries are exposed to high out-of-pocket expenditures.

“PSI patient assistance doesn’t just help save lives – it also drives down costs for cash-strapped government programs like Medicare. Without donation-based charities like PSI to help patients living with chronic and rare conditions cover the prohibitive cost of care, the government and taxpayers would be forced to foot the bill,” added Kuhn. “I founded PSI nearly 30 years ago as a temporary solution to help families navigate rising health costs. Unfortunately, costs continue to rise, patient lives hang in the balance, and the assistance that PSI provides has never been more vital.”

To read the full Avalere Health report, click here.

About Patient Services, Inc.

PSI is the “ground breaking” 501(c)(3) non-profit, charitable organization of its kind.  Founded in 1989 by Dana Kuhn, Ph.D., the Midlothian, Virginia based company helps people who live with specific chronic illnesses or conditions locate suitable health insurance coverage and afford costly premiums and copayments.  PSI restores hope and health to those living with chronic illness.

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