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Episode 249 - Dr. Louanne Bakk: Racial/Ethnic Differences in Cost-Related Nonadherence and Medicare Part D

Monday, October 08, 2018, 7:51:41 AM

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In this episode, our guest Dr. Louanne Bakk discusses her research examining how the enactment of Medicare Part D changed the lives of recipients. While the benefit assisted some, the costs borne by low-income participants appears to have fostered cost-related nonadherence with prescription medication use, which appears linked to racial and ethnic disparities.

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Average Rating: 5stars   important research , Sunday, February 10, 2019

By Jennifer M. :

Dr. Bakk has done very important research surrounding the effects of Medicare Part D on minority groups. She states that although it attempts to bring medication costs within the reach of lower income people, it has not solved the problem of affordability for older adults. Vulnerable minority groups have life-long cumulative disadvantages that pose constant challenges when it comes to affording medications. These challenges come in the form of high premiums, deductibles, and co-pays. Additionally, the low-income subsidy is underutilized since there is a great lack of awareness for this program within minority groups. So I believe she correctly identifies the need for social workers to raise awareness amongst older adult minority populations. Therefore, there is a great need for intervention and continued research in this area, to reduce health disparities within these groups.

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Average Rating: 5stars  racial/ethnic differences , Sunday, February 10, 2019

By Amanda :

This podcast did a phenomenal job explaining what Medicare Part D is along with some of the racial disparities that accompany this law. I found this podcast to be particularly informative, as someone who works in the field with insurance issues regularly. Dr. Bakk provided a detailed explanation of the law and why it was enacted in the first place. Along with this, we are also informed of the inflation of prescription drug costs that make it so difficult for Medicare patients to afford to live. Dr. Bakk is very sensitive to the nature of the clientele that she is speaking about. She understands many barriers Medicare participants face, especially non-white ethnicity. This podcast demonstrated some of Dr. Bakks research on Medicare Part D, which shows that the implementation of this law did not show a significant difference.
I really appreciate Dr. Bakk's opinion on how to look at this issue and how policies and procedures could aid in assisting these individuals. As someone who is working in the field, it is essential for me to be knowledgeable on this to aid my clientele. She believes that agencies should be more aware and educated to help these clients choose from the over 50 insurance plans that come with Medicare Part D. I believe it is also important to look at the delivery method we are providing this coverage to clients in. Are we giving massive packets, when perhaps the client may not understand the language, or be able to read? Or should we offer mobile sign ups where clients can walk up and hear an explanation of benefits. There are many ways to eliminate the racial and ethnic differences in cost-related non-adherence if we try; because as the interviewer said there are clients who are not getting their prescription drugs to eat, and that really is very avoidable.

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Average Rating: 5stars  cumulative disadvantage strikes again , Wednesday, February 06, 2019

By Adrienne :

In this podcast, Dr. Bakk did a great job of highlighting a serious public health issue while also simplifying and clarifying a very complex facet of Medicare Part D. Prior to listening to this podcast, I was not entirely sure how Medicare Part D worked, let alone its differential impact on low-income populations. In sharing her research, Dr. Bakk explains that Medicare Part D was designed to offset the exponential cost of prescription drugs, by building cost-sharing methods and other benefits into existing Medicare programs. In other words, the program was introduced as a strategy for helping individuals who were already receiving Medicare coverage to afford prescription drugs. Dr. Bakk explains that prior to the passage of Medicare Part D, lower-income populations had higher rates of cost-related noncompliance (i.e., not taking medications as prescribed, etc.) than higher-income populations - but after the passage of Medicare Part D, this disparity was statistically unchanged. In other words, this policy, designed to reduce barriers to prescription medication compliance, appears to be largely unsuccessful within lower-income populations. This disproportionately affects African American and Hispanic consumers.

After an interesting, albeit somber, discussion about how this issue relates to the concept of cumulative advantage/disadvantage, Dr. Bakk shares with listeners some concrete action steps that social workers and policymakers can take to reduce cost-related noncompliance among higher-risk populations. These action steps should focus on addressing health and healthcare literacy, taking a client-centered approach and sharing information about Medicare's low-income subsidy provision, and advocating for more effective policies that address this public health issue. This podcast helped to clarify an important issue that is often shrouded in politics and misconceptions. Definitely recommend!


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Average Rating: 5stars  trying to understand nonadherence , Monday, February 04, 2019

By Rebecca Adinolfe :

I found this podcast very interesting because I did not know much about Medicare Part D before listening to this podcast. Dr. Louanne Bakk describes the history of Medicare part D and what it does with great clarity. The implementation of Medicare Part D is a step in the right direction, but there are flaws. Cost of medication increases every year, and minority populations still struggle even with the benefits Medicare Part D provides. There is nonadherence due to cost, even with the benefit. Nonadherence is a complex and multidimensional healthcare problem where people are not able to follow recommendations for prescribed treatments. Not following a recommended treatment can result in all kinds of health benefits. Nonadherence is something that children learn at a young age. To describe this simply, when I was younger, I learned that if you got sick you would take medication that would fight off antibodies and it was essential to take all the medicine you were given, even if you felt better so that you would fully recover. Not being able to finish the medication could result in worsening symptoms. Antibodies and the common cold are my most simple version of explaining my understanding of nonadherence. Vulnerable groups, typically blacks and Hispanics, with lower socioeconomic status have higher nonadherence. Earlier experiences and a cycle of poverty can result in dependence of medication later in life. The benefits of Medicare Part D are not addressing racial disparities. The Elder population is too broad and should be broken down into the differences within it. There are issues surrounding language and education. Medicare Part D is not achieving equal access to the benefits. Social workers can tackle this issue by educating clients during intake and having harder conversations about their healthcare for better understanding. It’s a complex topic for anyone to understand, Social workers are there to educate and guide.

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