Policy solution championed by Prescriptions for a Healthy America allows coordination between Medicare Parts A and B claims data with Part D plans, helping identify patients most at risk for medication non-adherence
By: Hayden Bosworth, Duke University & Sloane Salzburg, Prescriptions for a Healthy America
For all the dizzying talk of repeal versus repair, one of the greatest cost drivers in healthcare is still hiding in plain sight. It’s called medication nonadherence: the simple fact that people often don’t take their medicines as prescribed.
Medications cost the healthcare system approximately $325 billion annually, and research indicates that suboptimal medication use—including taking too much or not taking enough—leads to avoidable annual healthcare costs totaling $300 billion. People who don’t take their medicines are more likely to end up back in the hospital or in the emergency room than those who do.
What can we do? Prescriptions for a Healthy America and Duke University’s Medication Adherence Alliance assembled a diverse group of experts from Washington D.C., California, North Carolina and many places in between, representing patients, physicians, pharmacies, pharmaceuticals and other life science organizations. Together, we coalesced around four priorities for fixing this problem...Read more here>>
WASHINGTON, DC, 5/18/17 - Prescriptions for a Healthy America (P4HA), the medication adherence campaign of the Council for Affordable Health Coverage, praised the Senate Finance Committee's passage of S. 870, the Creating High-Quality Results and Outcomes Necessary to Improve Chronic (CHRONIC) Care Act of 2017.
The committee-passed bill includes an amendment offered by Senators Tom Carper (D-DE) and Pat Roberts (R-KS) and championed by P4HA providing Medicare Parts A and B claims data to Part D Plans in order to enhance the effectiveness of current and future medication management programs. The P4HA-supported amendment was passed by a voice vote and was the only amendment passed out of committee.
P4HA Executive Director Sloane Salzburg released the following statement:
"Medication non-adherence is a $300 billion problem that claims the lives of at least 125,000 Americans each year. The Carper-Roberts amendment to the CHRONIC Care Act, vigorously supported by P4HA and its partners, offers a bipartisan, commonsense step towards addressing this challenge by ensuring better information about hospital and physician encounters is shared with Medicare drug plans. These encounters may change which medicines a patient can or should be taking, but today, plans have little to no information on an enrollee’s visits to hospitals or ambulatory providers," said P4HA Executive Director Sloane Salzburg. "As it stands today, there can be a dangerous disconnect between the clinical setting, where patients are diagnosed, and the pharmacy setting, where patients receive their medications. This amendment would better coordinate pharmacy and medical care so that Part D plans can identify patients most at risk of medication mismanagement and adapt their treatment plan accordingly. We believe this measure will reduce costs and, most importantly, save lives. P4HA is grateful to Senators Carper, Roberts, and members of the Senate Finance Committee for their leadership on this critical legislation."