The average monthly premium charged by Medicare Part D stand-alone prescription drug plans (PDPs), the only drug coverage plans available to all Medicare beneficiaries in large numbers, is $37, according to an analysis by Austin Frakt and Steven Pizer published May 23 on the Health Affairs Web site. That's well above the $19 average monthly drug premium charged by local Medicare Advantage (MA) HMOs and the $22 monthly drug premium charged by Medicare's regional preferred provider organizations. About half of the PDPs have no drug deductibles, as compared with three-quarters of HMO plans.

Employees in firms with fewer than ten workers paid 18 percent more for health insurance in 2002, after adjusting for actuarial value, than employees of firms with over 1,000 workers, Jon Gabel and coauthors report in the May/June Health Affairs. The average actuarial value for all employer-based plans rose eight percentage points from 1997 to 2002, largely because networks grew broader and workers migrated to plans using fixed-dollar copayments. In 2002, adjusted employer-based premiums for HMOs were 25 percent below indemnity premiums, so workers in indemnity-heavy rural states faced higher premiums than residents of HMO-heavy urban states.

"As competition increases, health plans attempt to risk-select through advertising." That's the conclusion offered in the May/June Health Affairs by Ateev Mehrota and coauthors, who found that health plan advertising attractive to healthy people increased from the 1970s through the 1990s, as HMOs became more common and gained market share. Moreover, in 2000, such ads -- showing people at work or engaging in physical activity, for example - were more common in markets with higher HMO penetration. Monitoring advertising could be a novel way of detecting risk selection by Medicare drug plans, the researchers suggest.