^Python based healthcare finance application analyzing patient cost exposure and downstream revenue implications under the Medicare Part D redesign.

 

Overview:

This project is a Python based healthcare finance application designed to evaluate the impact of the Medicare Part D redesign on beneficiary out of pocket costs and financial outcomes. The redesign in 2025 introduced an annual out of pocket cap that materially changed patient cost exposure. These changes have downstream implications for utilization and manufacturer revenue. The model simulates patient spending under the new cap and has specific scenario based assumptions to calculate assumed utilization and net revenue. I built this because I’m interested in how big policy changes can trigger financial decisions for both manufacturers and patients.

• Built as a Python application

• Used pandas for data calculations

• Scenario based framework enabling sensitivity analysis

Key Problem: How does this redesign change beneficiary out of pocket spending?

There were fairly recent changes to Medicare Part D that significantly altered beneficiary cost sharing through the introduction of an annual out of pocket cap. While these changes aim to reduce patient financial burden, they cam also affect utilization patterns, gross to net dynamics, and manufacturer revenue. Understanding these downstream effects would be critical for healthcare organizations operating in regulated markets.