Business Finance
HSA 4700 FAU Three Prescription Drug Plans Summary Report

HSA 4700

Florida Atlantic University

HSA

Question Description

I don’t understand this Excel question and need help to study.

Prepare custom summary report of top three Prescription Drug Plans (PDPs)

  •  Use Medicare Plan Finder to get information on PDPs.
    This web-based consumer tool provides a great deal of information. Because PDPs can differ in so many dimensions, the sheer volume of information is hard to process.
  •  Design and create a one-page-per-PDP sheet for the three lowest-cost PDPs. There is no pre-defined format or content for these summaries. Originality and creativity are encouraged in the hope of finding new and effective ways of compressing a large amount of PDP information into smaller package.(There are a few minimum requirements, spelled out in section 3.1)
  •  Design and create a one-page-summary of the 3 PDP sheets. Again, there is no pre-defined format or content for these summaries.


My selected drugs are:

Fluticasone / salmeterol 250- 50mcg/dose aerosol powder ||| Package:[Dispensable pack of 60 aerosol powders], Quantity:[1], Frequency:[Every month], Generic- Brand:[Generic]

Gabapentin 400mg capsule ||| Package:[], Quantity:[30], Frequency:[Every month], Generic-Brand:[Generic]

Humira 40mg/0.8ml pen injector kit ||| Package:[Box of 1 pen injector kit (sold in pack of 2)], Quantity:[1], Frequency:[Every month], Generic-Brand:[Brand]

Spiriva 18mcg capsule ||| Package:[Box of 30 capsules], Quantity:[1], Frequency:[Every month], Generic-Brand:[Brand]


Attached is an example of what another tutor did, except he did not choose the lowest three plans or cvs and Walgreens as the pharmacy.


also attached is a previous students work.

Unformatted Attachment Preview

Hinfo Tools & Training Medicare drug plans. Project to design and compare summary reports. Medicare drug plans. Project to design and compare summary reports. How to use these instructions.    Review these instructions, the accompanying tutorial videos and the Excel template. The tutorial and template include dates, places and plans that do not match these instructions. Rely on these instructions for specific dates, places, plans and other parameters; the tutorial and template are used only to demonstrate techniques. The tutorial and template show one possible approach to generating required ratios, summaries, statistics and graphs. Basically, the tutorial shows just one possible path from raw data to required outputs; other paths may also work. 1 2 Project overview....................................................................................................................................... 2 Introduction ............................................................................................................................................... 3 2.1 Medicare Prescription Drug Plan (PDP) search tool. ....................................................... 3 2.2 Hypotheses – What questions is the project asking? ...................................................... 4 2.3 Applications – Who can use project findings? ................................................................... 5 2.4 Data Access ...................................................................................................................................... 6 3 Steps ............................................................................................................................................................. 7 3.1 Data Collection ................................................................................................................................ 7 3.2 Report Preparation ......................................................................................................................10 4 Performance assessment....................................................................................................................12 4.1 Peer Review ....................................................................................................................................12 4.2 Peer Citizenship. Your performance as a reviewer. .......................................................12 4.3 Grade sheet ....................................................................................................................................13 5 Prescription shopping cart assignments ......................................................................................14 Copyright: 3/9/20, Hinfo.org (p020-student-assign.docx) Page 1 of 21 Hinfo Tools & Training 1 Medicare drug plans. Project to design and compare summary reports. Project overview Exhibit 1. Project overview Prepare custom summary report of top three Prescription Drug Plans (PDPs)  Use Medicare Plan Finder to get information on PDPs. This web-based consumer tool provides a great deal of information. Because PDPs can differ in so many dimensions, the sheer volume of information is hard to process.  Design and create a one-page-per-PDP sheet for the three lowest-cost PDPs. There is no pre-defined format or content for these summaries. Originality and creativity are encouraged in the hope of finding new and effective ways of compressing a large amount of PDP information into smaller package. (There are a few minimum requirements, spelled out in section 3.1)  Design and create a one-page-summary of the 3 PDP sheets. Again, there is no pre-defined format or content for these summaries. Evaluate PDP summaries created by colleagues.  Everyone on this project will assess each other’s work.  This project is part of a larger research campaign aimed at improving the information tools for Medicare consumers. An important step in the development of any new consumer product is to have the ‘design team’ review alternate designs and identify best practices. (Everyone on this project is part of the ‘design team’.) Copyright: 3/9/20, Hinfo.org (p020-student-assign.docx) Page 2 of 21 Hinfo Tools & Training 2 Medicare drug plans. Project to design and compare summary reports. Introduction 2.1 Medicare Prescription Drug Plan (PDP) search tool.  Many insurance companies have decided to offer Medicare Prescription Drug Plans (PDPs) in a number of market areas. Some counties have over 20 separate PDP options from which Medicare beneficiaries can choose.  To help consumers get accurate information and make the best decision for themselves, Medicare has a web-based “Plan Finder” tool (www.Medicare.gov).  Although most consumers like to have a choice, the decision can be quite complex because of the number of variables: o Drug coverage varies from one policy to the next.  One PDP might cover all five drugs used by an individual, while another PDP may cover only four, meaning that individual would have to pay the entire cost of that uncovered drug under some PDPs but not others. o Amount paid depends on PDP.  The same drug may require a $5 copay by one PDP and $10 by another. That difference may even exist between two PDPs offered by the identical insurer. o Amount paid depends on pharmacy.  The same drug may require a $5 copay at CVS and $10 at Walgreens – even for the same PDP. o Consumer out-of-pocket (OOP) spending depends on timing.  OOP spending at the pharmacy depends on whether I have met my deductible, spent enough to fall into the coverage gap (“donut hole”), or spent even more to qualify for catastrophic coverage.  In this setting, even the average consumer can be faced with 400 different scenarios: o 20 PDPs to pick from * 5 different drugs * 4 different pharmacies = 400 scenarios. Copyright: 3/9/20, Hinfo.org (p020-student-assign.docx) Page 3 of 21 Hinfo Tools & Training 2.2 Medicare drug plans. Project to design and compare summary reports. Hypotheses – What questions is the project asking?  This project gives participants the opportunity to design and compare alternative custom summary reports. It does so by asking the following questions: o How can PDP information be presented to allow consumers to make optimal decisions?  Each participant designs a new custom summary report format of their own making, compressing Medicare Plan Finder information to just a few pages. Implicit in this design is the assumption that consumers have limited time to make decisions, so in addition to accuracy and picking relevant data, report designs should minimize the amount of information presented. o Which new formats are most preferred by consumers?  Participants examine each other’s custom summary reports with the goal of identifying those formats that deserve further testing.  This project contributes to the broader goal of improving the information tools that allow Medicare beneficiaries to make optimal decisions regarding their choice of PDPs. In effect, it is an idea incubator or laboratory. Designs, templates and summary tools envisioned here may eventually be used by millions of future Medicare beneficiaries, enabling them to make insurance choices that keep healthcare affordable and make their lives longer, healthier and happier. Copyright: 3/9/20, Hinfo.org (p020-student-assign.docx) Page 4 of 21 Hinfo Tools & Training 2.3 Medicare drug plans. Project to design and compare summary reports. Applications – Who can use project findings?  There are many areas that use custom summary reports of Medicare PDP policies.  Consumers can use these reports to choose the PDP that enables them to get necessary medications at the lowest cost.  Insurers can use these reports to measure policy competitiveness and profitability. For example, for patients using a standard ‘basket’ of diabetesrelated drugs, does the insurer make a profit on a particular PDP? For that same patient, how does the insurer’s PDP offerings compare against competitor PDPs.  Pharmacies can use such reports to make it easy for consumers to find the PDPs for which that particular pharmacy is the lowest cost alternative. Basically, this shows consumers the lowest cost PDP if they really want to stay with their pharmacy.  Drug manufacturers can package these reports as ‘education’, showing consumers which PDPs cover their most popular drugs.  Physicians can use these reports to do ‘what if’ analysis when considering alternatives for patients whose PDP does not cover the physician’s first choice of prescription.  Support groups can use these reports to advise members about those PDPs that provide the most generous coverage for the range of drugs needed to treat their condition. Copyright: 3/9/20, Hinfo.org (p020-student-assign.docx) Page 5 of 21 Hinfo Tools & Training 2.4 Project to design and compare summary reports. Data Access  This project compresses the large amount of Medicare Prescription Drug Plan (PDPs) data into a more-compressed, consumer-friendly format. The format is not predefined. Participants must use their individual creativity to design their brand-new, one-of-a-kind custom summary report template. That template will then be evaluated by peers with the goal of identifying promising techniques. In the near future, this project will then take these designs and test with actual consumers.  The Medicare Plan Finder is an on-line tool (www.Medicare.gov) for comparing Medicare PDPs, as well as Medicare Advantage plans1. This web site gives consumers easy access to a wealth of information about PDPs. This wealth of information is a double-edged sword. On the positive side, having all available details provides full disclosure and enables consumer decision making. On the negative side, however, is the tremendous effort required to sort through those details. As the decision starts to look more like a math project requiring hours of focused attention, many consumers may get discouraged, skipping the analysis altogether, and simply make a quick decision that often makes it more expensive for them to afford needed medications. This project is about compressing that large mass of data into a custom summary report that allows consumers to focus on what is most relevant to their decisions. Basically, finding the tables, graphs and descriptions that empower consumers to identify the PDP that best suits their needs. This project takes an experimental approach. The ‘best format’ for presenting PDP information has not yet been identified, so this project is not about creating specifically formatted tables, graphs or reports. Rather, this project asks for the creative generation of many alternative custom summary report templates. These alternatives will then be reviewed by peers to identify those ‘tricks’ that work best. Remember that all of this is based on data already freely available on the Medicare Plan Finder consumer tool, so these ‘tricks’ are just ways of sorting, compressing, graphing or explaining that information that makes it easier for consumers to quickly digest. Seen in this broader context, this project is a step in helping consumers make better health-related decisions, ultimately leading to longer, healthier, happier lives.      1 Medicare drug plans. Accompanying tutorial video recorded Mar-2020 . Copyright: 3/9/20, Hinfo.org (p020-student-assign.docx) Page 6 of 21 Hinfo Tools & Training Medicare drug plans. Project to design and compare summary reports. . 3 Steps . 3.1 Data Collection .  Task summary in Exhibit 2 accompanies the tutorial video for this project. . Exhibit 2. Overview of data collection task. https://www.medicare.gov/ Find plans. Find 2020 health & drug plans. Continue without logging in What type of 2020 Medicare coverage do you want?  Drug plan (Part D) Zip code: 33411 Do you get help with your costs from one of these programs?  I don't get help from any of these programs Do you want to see your drug costs when you compare plans?  Yes How do you normally fill your prescriptions? Both ENTER DRUGS. Each student has a personalized list of 4 drugs. Listed under grade book ID in Exhibit 7. Pharmacy selection:  CVS #17053; 10155 Okeechobee Blvd, WPB, FL 33411  Walgreens, 9921 Okeechobee Blvd, WPB, FL 33411 27 Prescription Drug Plans available Sort plans by:  Lowest drug + premium cost  Add to compare For the three lowest drug + premium cost plans Compare (at bottom of screen) – to get more information on each Plan Details. For each of the top 3 lowest drug + premium cost plans. Copyright: 3/9/20, Hinfo.org (p020-student-assign.docx) Page 7 of 21 Hinfo Tools & Training Medicare drug plans. Project to design and compare summary reports. .  The goal of this PDP plan search is to gather information needed to prepare helpful consumer summaries. Suggestions on the data that should be collected along the way are summarized in Exhibit 3. o The Plan Search tool does not provide an option to download PDP coverage data to Excel, so much of the data collection will be manual. It will be easier if this task is performed using two separate full-sized monitors. Exhibit 3. Information to collect for each plan. Plan name and ID (full plan name) Phone number Retail pharmacy: Estimated total drug + premium cost Mail order pharmacy Estimated total drug + premium cos Drug plan (Part D) monthly premium Drug deductible Estimated total drug + premium cost Separately for all 3 providers (two pharmacies and mail order) Estimated monthly drug costs Separately for all 3 providers (two pharmacies and mail order) Drug costs during coverage phases Separately for all 3 providers (two pharmacies and mail order) Other drug information: Prior authorization Quantity limits Step therapy Total costs for remaining year Total costs for remaining year Record monthly totals.  Too much information to put on consumer, but helps you do the detailed computations that will produce simple "total out of pocket by drug, by month" costs that WILL help consumer.  For the plan-specific page, it would help if there were 3 columns: one for each provider showing out-of-pocket by month. Record costs for each drug.  This is too much information for consumer, but combined with the prior item, it gives you the information needed to compute detail spending by month, by drug.  This level of analysis is needed only for the provider with the lowest overall cost. You will want to report this for each drug. . Copyright: 3/9/20, Hinfo.org (p020-student-assign.docx) Page 8 of 21 Hinfo Tools & Training Medicare drug plans. Project to design and compare summary reports. .  Although you will collect information on 3 different providers (2 drug stores and mail order) for each plan, the plan detail page should focus as follows: o Total annual OOP spending for each provider. o Detail OOP by month ONLY for the lowest cost pharmacy (not including the mail order option). You can add in the detail if you think it will help consumers, but given that the OOP by month may already have separate columns for each drug, it would start to get complex.  Resources to help understand copays, deductibles, donut holes, etc: o General overview  https://www.medicare.gov/drug-coverage-part-d/costs-formedicare-drug-coverage o Explanation of the donut hole  https://www.youtube.com/watch?v=BoDale2UZ40  https://www.youtube.com/watch?v=ygVMZ1UfPcU o Videos of other people using the web site  https://www.youtube.com/watch?v=yd-DUpIuTA0  https://www.youtube.com/watch?v=eZYO61st9eQ  No template for this assignment o A large part of this project asks you to creatively organize information for something that is still waiting for a 'standard template' to be defined. o There are no universally accepted standards for what information is needed, what is not, and how it should be displayed. o Instead, this assignment highlights certain information that is sure to help consumers. It is up to you to decide how to best do that. Copyright: 3/9/20, Hinfo.org (p020-student-assign.docx) Page 9 of 21 Hinfo Tools & Training . 3.2 . Medicare drug plans. Project to design and compare summary reports. Report Preparation  The goal of this PDP plan search is to gather information needed to prepare helpful consumer summaries. Suggestions on the general format of those summaries are in Exhibit 4. Exhibit 4. Custom Summary Report Production. Total number of pages = 4. # pages Content Comments 3 One-page-per-PDP Format of each PDP sheet should be fairly sheet consistent. (Same headings, same layout, etc). Makes it easier to compare. 1 Single page summary Can introduce new content that was not on one-page-per-PDP sheets. Page size = 8.5 * 11. Font no smaller than 10 point.  Margins between 0.5-1.0. on all sides. No larger. No smaller.  Font in graphs (in final printed form) must be at least 10 point. PDF printout (based upon Word or Excel work file).  Must be submitted as PDF. (No password protection.)  Work version must be in Word or Excel. No identifying information.  In order to keep the peer review ‘blind’, author names should not appear on custom summary report.   Note that the data collection was not really the hard part. You will have to create Excel spreadsheets that sort through deductibles, copayments, donut holes and catastrophic coverage. BUT SHOWING ALL OF THIS TO THE CONSUMER WILL ONLY CONFUSE THEM. It is tempting to show the reader all your hard work, but that can go in an appendix. Start with a simple summary that will help ALL consumers. Recommended minimum content is presented in Exhibit 5 . . Copyright: 3/9/20, Hinfo.org (p020-student-assign.docx) Page 10 of 21 Hinfo Tools & Training Medicare drug plans. Project to design and compare summary reports. Exhibit 5. Custom Summary Report Content – Required, but not minimum Remaining year  Assume this report is just for months remaining in the current year (the default for the plan search tool). Required for each PDP  Indication if any drug is not on formulary, or if any drug requires steptherapy. Should be stated explicitly, even if the answer is ‘no’.  Indication of the two most expensive drugs used by the consumer. Measured based on total annual consumer out-of-pocket spending (copays and deductibles only; exclude premiums). State drug name and annual amount.  Indication of which pharmacy (or mail order option) is least expensive for this particular PDP.  Highest monthly out-of-pocket spending amount and the month when it occurs. And the same for the lowest out-of-pocket spending amount. In case of a tie, simply report the first month. Required on single-page summary of all 3 plans  Recommendations that state which PDP is lowest cost, second-lowest.  Copy of drug list used to generate analysis. Quality ratings not needed  To keep this project focused on presenting cost information, there is no need to include PDP quality and satisfaction ratings. Adequate detail for informed consumer decision  There is much more needed on the custom report than the minimums listed above. Listing expectations, however, would interfere with the creative process. So the direction is simple: Create a short document which helps consumers make the best possible PDP choice, and to be aware of close alternatives.  This requirement obviously calls for much more than the simple minimums stated here. This openness is done intentionally to maximize creativity. . . . Copyright: 3/9/20, Hinfo.org (p020-student-assign.docx) Page 11 of 21 Hinfo Tools & Training . 4 Medicare drug plans. Project to design and compare summary repor ...
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Final Answer

Okay. Sometimes they still get upset with us... I finished the first page (took me the longest because of formatting but the other two will be quicker since I can copy and paste my formatting... I'll send it over so you can let me know if you like it.

Humana Walmart Value Rx Plan (PDP)

Medications

Plan ID: S5884-190-0
Phone Members: 1-800-281-6918 Nonmembers: 1-800-706-0872
Total out-of-pocket for year: $5,295.83

Covered
Yes

Fluticasone/salmeterol (250-50
mcg/dose aerosol powder)
Gabapentin (400mg capsule)

Yes

Humira (40mg/0.8ml pen injector kit)

Yes

Spiriva (18mcg capsule)

Yes

Monthly Premium: $13.20
Yearly Deductible: $435

*** Drug Requires Prior Authorization

CVS PHARMACY

CVS Pharmacy Yearly Out-of-Pocket

Your total annual out-of-pocket cost
for the year is $5295.83 with this
pharmacy and plan.
CVS is the least expensive pharmacy
based on out-of-pocket drug spending
for the entire year. This price includes
your yearly deductible, premiums,
and co-pay.
The highest out of pocket cost occurs
in April with a total of $1960.54
including deductible and premium.
The lowest monthly cost will occur
from June through December with a
total monthly cost of $344.35

Month
April
May
June
July
August
September
October
November
December
Total

Monthly
Premium
$
13.20
$
13.20
$
13.20
$
13.20
$
13.20
$
13.20
$
13.20
$
13.20
$
13.20
$ 118.80

Combined Total
for the year

$5,295.83

All four medications are covered by this plan. This plan requires
prior authorization for the drug Humira. This means that your
doctor has to request it before it is covered by the plan.

Yearly
Deductible
$ 435.00

$

435.00

Out-of-Pocket
Cost
(copayment)
$
1,512.34
$
911.64
$
331.15
$
331.15
$
331.15
$
331.15
$
331.15
$
331.15
$
331.15
$
4,742.03

Humira and Spiriva are the most expensive drugs
covered by this plan. With CVS you pay $1,458.83 after
deductible for Humira and $47.00 for Januvia monthly.

CVS Pharmacy Out-of-Pocket by Month

Total
December
November

CVS Pharmacy Yearly Out-of-Pocket Monthly
Premium

October
September

CVS Pharmacy Yearly Out-of-Pocket Yearly
Deductible

August

CVS Pharmacy Yearly Out-of-Pocket Out-ofPocket Cost (copayment)

July
June
May
April
$-

$1,000.00

$2,000.00

$3,000.00

$4,000.00

$5,000.00

$6,000.00

Cigna-HealthSpring Rx Secure-Extra (PDP)
Total out-of-pocket for year: $7,551.00
Monthly Premium: $65.30
Yearly Deductible: $100.00
It has a low monthly premium and a low deductible but requires step therapy for one of the drugs. All
drugs are covered in this plan. Humira and Januvia are the most expensive drugs on the plan. The lowest
cost pharmacy is Walgreens for this plan.

BlueMedicare Premier Rx (PDP)
Out-of-pocket for year: $8,801.03
Monthly Premium: $167.30
Yearly Deductible: $0.00
It has a very high monthly premium and no deductible. It does not require step therapy. All drugs are
covered in this plan. Humira and Januvia are the most expensive drugs on the plan. The lowest cost
pharmacy is Walgreens for this plan.

Express Scripts Medicare - Choice (PDP)
Out-of-pocket for year: $7,411.46
Monthly Premium: $87.60
Yearly Deductible: $250.00
It has a low premium and relatively high deductible. It does not require step therapy. All drugs are
covered in this plan. Two out of the four pharmacies are out of network. This leaves fewer options for
pharmacy selection. Humira and Januvia are the most expensive drugs on the plan. The lowest cost
pharmacy is Walgreens for this plan.

RECOMMENDATION:
I recommend Express Scripts Medicare-Choice (PDP). While this plan does have the highest deductible
out of the three, it will be met in January. It doesn’t require step therapy like Cigna-HealthSpring Rx
Secure-Extra (PDP). Its monthly premium is not high like BlueMedicare Premier Rx (PDP). It also has
the lowest combined out-of-pocket for the year out of the three.

Finished :) Let me know what you think

Humana Walmart Value Rx Plan (PDP)

Medications

Plan ID: S5884-190-0
Phone Members: 1-800-281-6918 Nonmembers: 1-800-706-0872
Total out-of-pocket for year: $5,295.83

Covered
Yes

Fluticasone/salmeterol (250-50
mcg/dose aerosol powder)
Gabapentin (400mg capsule)

Yes

Humira (40mg/0.8ml pen injector kit)

Yes

Spiriva (18mcg capsule)

Yes

Monthly Premium: $13.20
Yearly Deductible: $435.00

*** Drug Requires Prior Authorization

CVS PHARMACY

CVS Pharmacy Yearly Out-of-Pocket

Your total annual out-of-pocket cost
for the year is $5295.83 with this
pharmacy and plan.
CVS is the least expensive pharmacy
based on out-of-pocket drug spending
for the entire year. This price includes
your yearly deductible, premiums,
and co-pay.
The highest out-of-pocket cost occurs
in April with a total of $1960.54
including deductible and premium.
The lowest monthly cost will occur
from June through December with a
total monthly cost of $344.35

Month
April
May
June
July
August
September
October
November
December
Total

Monthly
Premium
$
13.20
$
13.20
$
13.20
$
13.20
$
13.20
$
13.20
$
13.20
$
13.20
$
13.20
$ 118.80

Combined Total
for the year

$5,295.83

All four medications are covered by this plan. This plan requires
prior authorization for the drug Humira. This means that your
doctor has to request it before it is covered by the plan.

Yearly
Deductible
$ 435.00

$

435.00

Out-of-Pocket
Cost
(copayment)
$
1,512.34
$
911.64
$
331.15
$
331.15
$
331.15
$
331.15
$
331.15
$
331.15
$
331.15
$
4,742.03

Humira and Spiriva are the most expensive drugs
covered by this plan. With CVS you pay $1,458...

svantass (386)
UC Berkeley

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