The Maryland Health Exchange would benefit from improvements, according to a recently-released study by the Partnership to Fight Chronic Disease. The Partnership to Fight Chronic Disease (PFCD) is a coalition of hundreds of patient, provider, community, business and labor groups, and health policy experts, committed to raising awareness of chronic disease. Ken Thorpe, chairman of […]
The Maryland Health Exchange would benefit from improvements, according to a recently-released study by the Partnership to Fight Chronic Disease.
The Partnership to Fight Chronic Disease (PFCD) is a coalition of hundreds of patient, provider, community, business and labor groups, and health policy experts, committed to raising awareness of chronic disease.
Ken Thorpe, chairman of the PFCD, conducted a study on the impact of increased costs on patient access and prescription drugs. According to Thorpe’s study, when cost sharing in health insurance plans is higher some patients may forego their physician-prescribed medications in order to save money—especially when people are diagnosed with long-term illnesses.
Based on the model utilized in the study, reduction in drug adherence by chronically-ill patients could result in $142 million in increased hospital spending in Maryland over the next five years.
“Health insurance can be a daunting topic, and even more so if you are struggling with one or more chronic diseases and have some very specific needs,” Thorpe said. “Our hope with the study was to highlight for policy makers the difficulties that still exist for patients with chronic disease and how we can address those issues to better serve every Marylander regardless of their health status.”
Andrew Ratner, director of marketing and outreach for the Maryland Health Benefits Exchange, said the exchange is not aware of the study, but continues to work on improving its program as it moves into the future.
“We’re pleased that more than 190,000 have enrolled for quality and affordable health coverage through Maryland Health Connection so far with nearly two weeks remaining in open enrollment,” Ratner said. “But we also know that this is still a very new program with much room to grow in terms of access, outreach and information.”
Thorpe said health care companies use cost sharing as a ploy under federal law to discourage people from marginal or unnecessary use of drugs they are prescribed. But for chronically ill patients, he said, ongoing medication maintenance and refills can be problematic because of the cost.
According to the study, when patients skip medications their health can decline, which could create a need for more invasive procedures and higher hospital costs. Thorpe said enrollees are also not always aware of the high costs they will have to pay from cost sharing because the policy is not transparent about those costs.
“What we’re doing (in the study) is comparing people with different chronic diseases and looking at what they would pay out of pocket in a typical employer-based plan versus what they would pay out of pocket for a silver plan offered through the exchange,” Thorpe said. “The bottom line is that, by design, the silver plan’s cost sharing is much higher compared to an employer plan. People would spend a lot more out of pocket to fill and refill their prescriptions.”
In addition to Thorpe’s study, MedChi, a Maryland medical society organization serving physicians and patients in the state, conducted a poll of 500 likely 2016 Maryland voters. According to MedChi, 82 percent of people would like for insurance companies to be more open and transparent about drugs that are covered on their plans and what costs they will have to pay.
“They wanted improvements. They wanted it to be better and they strongly supported the recommendations that we made,” MedChi CEO Gene Ransom said.
Ratner said the MBHE is not aware of the MedChi poll.
Ransom said the Maryland Health Exchange should focus on improving its website by enabling access to transparent, dependable health care coverage, reasonable cost-sharing for prescription medicines, stronger physician networks, and the availability of plans that do not discriminate based on disease.
“Maryland is doing better than other states on this, but still, we think we need to streamline this and make sure that it’s being implemented fairly and completely,” Ransom said. “We do believe that these protections are key and important to having this really work and fulfilling that promise. We want folks to not just have an insurance card but people they can go and get help from.”
Ransom said MedChi hopes to work with legislators to determine what changes in policy can be made to help people enrolled in the Maryland Health Exchange.