Choice, Numeracy and Physicians-in-Training Performance

The Case of Medicare Part D

Having better skills with numbers helped medical students and internal medicine residents choose Medicare Part D prescription plans that minimized costs.

Medicare Part D beneficiaries often require help from their physicians to find the right prescription plan. Finding the correct plan requires the ability to process complex numerical data. This study examined whether physicians’ numeracy skill-levels affected their ability to evaluate Medicare Part D prescription plans; in addition, the study examined physicians’ choices when there were more prescription plans available.

Medical students and internal medicine residents compared Medicare Part D prescription plans. Each participant compared one set of 3, 10, or 20 prescription plans (most Medicare Part D markets offer more than 50). The study evaluated whether participants chose the plan that: minimized total annual costs; minimized costs when mail-order was an option; included the most pharmacies; and included the pharmacy most convenient for patients when mail order was not an option. Participants completed a separate 11-item scale that assessed numeracy skills.

Key Findings:

  • More than two-thirds (68%) of participants chose the best prescription plan.
  • Those who compared either 10 or 20 plans were less likely to choose the plan that minimized total annual cost.
  • The number of plans and numeracy skill-level were significant predictors of whether a participant chose the correct plan.

The Medicare Part D prescription drug program is complex. Medicare Part D beneficiaries expect their physicians to help choose the best prescription plan. The findings of this study indicate that even highly-educated physicians may have difficulty choosing the Medicare Part D prescription plan that is most beneficial for their patients.