BACKGROUND AND OBJECTIVES The emotion of guilt plays a pivotal role in the genesis and maintenance of Obsessive-Compulsive Disorder (OCD). But what kind of guilt do OC patients want to prevent? Several studies suggest the existence of two different types of guilt emotions, namely deontological and altruistic guilt. This research suggests that the former, more than the latter, is involved in OCD...

BACKGROUND The Medicare Prescription Drug, Improvement, and Modernization Act, signed into law in 2003, provided access to prescription drugs for elderly Americans. The Part D benefit continues to evolve. Changes in plan designs, the impact of the doughnut hole on beneficiaries, and increased cost shifting have the potential to hamper the future of the Part D benefit. OBJECTIVE To discuss fac...

Low antihypertensive medication adherence is common. During recent years, the impact of low medication adherence on increased morbidity and healthcare costs has become more recognized, leading to interventions aimed at improving adherence. We analyzed a 5% sample of Medicare beneficiaries initiating antihypertensive medication between 2007 and 2012 to assess whether reductions occurred in disco...

BACKGROUND Current guidelines for acute coronary syndrome recommend clopidogrel for an optimal period of 12 months in order to reduce the risk of reinfarction and mortality. Premature clopidogrel discontinuation has been associated with higher rates of rehospitalization, coronary stent thrombosis, and mortality. No data exist regarding the effect of the Medicare Part D coverage gap on medical c...

Given Medicare’s recent national coverage decision on bariatric surgery, as well as potential coverage expansions for other obesity-related treatments, data on obesity in the Medicare population have great relevance. Using nationally representative data, we estimate that between 1997 and 2002, the prevalence of obesity in the Medicare population increased by 5.6 percentage points, or about 2.7 ...

The creators of the Medicare Advantage (MA) program envisioned that seniors would opt out of fee-for-service Medicare to take advantage of the lower premiums, lower cost-sharing, and additional benefits available in private plans. Earlier research, however, indicates that out-of-pocket costs for MA enrollees vary widely by health status and plan benefit package. This issue brief examines out-of...

Under the new Medicare drug benefit, beneficiaries residing in nursing homes and other long-term care (LTC) facilities have the same wide selection of Part D prescription drug plans available to community-dwelling beneficiaries. However, Part D does not alter Part A coverage for drugs during qualified skilled nursing facility (SNF) stays. This raises questions of whether drug utilization patter...

An earlier study of Federal civil-service annuitants.’ based on a IO-percent sample. showed that more than 4 out of 10 of the nearly 1 million annuitants on the rolls in December 1975 were alsn receiving cash benefits under the old-age, survivors, disability, and health insurance (OASDHI) program. Most of these “dual beneficiaries” were “primary beneficiaries”-that is. they were entitled to soc...

The Medicare drug benefit (Medicare "Part D"), provides federal subsidies to pay premiums and cost sharing for low-income beneficiaries--almost 10 million in 2009. Yet there are several policy issues concerning these low-income beneficiaries under Part D. First, over 2 million individuals who may qualify for the subsidies have not enrolled. Second, in some states, low-income beneficiaries have ...

Medicare Part D became available in 2006, offering millions of Americans the potential for improved access to medications. Certain aspects of the program have been problematic or confusing for vulnerable beneficiaries, but creative efforts across the country have helped individuals obtain and use the Part D benefit. Coalitions supply the information, training, and support that community partner...