Impact of Medicare Part D on osteopathic physicians

Although there is a wealth of information for patients and physicians on the Medicare Prescription Drug, Improvement, and Modernization Act, little research exists related to its impact on osteopathic physicians (DOs).

To examine the impact of Medicare's prescription drug benefit-or Part D-on DOs and their practices.

Two electronic surveys regarding Medicare Part D were e-mailed to DOs randomly selected from the American Osteopathic Association database. The first survey was sent January 31, 2006 (within the first month of Part D implementation), and the second was sent June 1, 2006 (6 months after implementation). Both surveys focused primarily on the challenges experienced by DOs and their staff regarding Part D. Responses were subjected to univariate, bivariate, and Pearson product moment correlation analysis.

Of the 10,000 DOs contacted, 603 (6%) responded and met inclusion criteria for the first survey and 343 (3.4%) for the second survey. More than 60% of respondents to the first survey reported challenges such as increased workload, difficulties understanding Part D, difficulties with the physician appeals process, and lack of information and education. These challenges were also reported in the second survey but by approximately 30% fewer respondents. One challenge-changing medications as a result of formulary restrictions-was reported by 17% more respondents to the second survey (P<.01). Respondents in primary care, solo practice, and rural areas as well as those treating large Medicare populations and those who were their patients' primary source of information about Part D reported more challenges.

Considering the numerous challenges respondents faced with Part D, it is important to remember the role of physicians in successfully implementing healthcare programs, particularly as the US healthcare reform debate progresses.