The millions of seniors in the Low-Income Subsidy (LIS) program are a special population. As seniors, they experience longer lives and higher instances of chronic conditions that require multi-drug therapies to manage. As low-income recipients, they rarely have job security, providers they trust, or a clear understanding of what healthcare services are available to them and at what cost. This is a dangerous combination, and the result is a population with highly increased incidences of:

  • Inpatient admissions.
  • Polypharmacy patients.
  • Hospitalizations from drug interactions.
  • Poor medication adherence rates.
  • Self-medicating (or, equally harmful, skipping or not taking medications as prescribed).

When we consider that the number of those aged 65 years and older will double in the next decade, the problem becomes clear: MAPD plans are facing a massive influx of high-risk, high-cost members.

Fast Facts

Of the 42 million enrolled in Medicare Part D in 2015:
15+ million were enrolled in MAPD plans.
30+ million were in the LIS program.
48% were between the ages of 65 and 74 (and 90% are 65+).

LIS Care and Opportunities for MAPD Plans

With the uniqueness of the LIS population comes an equally unique opportunity for MAPD plans: even small changes can make big differences. Specifically, plans can improve member care and outcomes among seniors by addressing key factors. Plans should:

  • Identify members at risk for medication misuse, overuse, or non-adherence. This can be accomplished by analyzing claims data and utilizing software and other technology to drive targeted, prioritized member lists.
  • Develop chronic condition quality improvement measures and interventions. This can be impactful if focused on the primary conditions senior LIS members suffer from – such as diabetes, hypertension, and opioid abuse.
  • Implement programs designed to correct over-prescribing and enhance medication education among members. This is achievable when future medical cost savings and readmission rates can be predicted and linked to medication adherence rates.

Successful LIS Healthcare Programs

It’s true that LIS seniors need support from plans to overcome many of the longstanding barriers to care that they face, such as cost and education. It’s also true that MAPD plans don’t have to take this on alone. RxAnte offers a wide range of tools and tactics to design, execute, and maintain programs for health plans. With predictive analytics and smart interventions, we partner with MAPD plans every day to drive real change for your target populations.

See one of our targeted solutions in action with Medicaid members on asthma controller medications.