How Can We Address Barriers to Accessing Needed Care?

American Journal of Pharmacy Benefits

In the latest issue of the American Journal of Pharmacy Benefits, National Pharmaceutical Council Chief Science Officer Robert Dubois, MD, PhD, outlines some of the challenges consumers are facing with high-deductible health plans (HDHPs) and suggests potential ways to improve these plans.

HDHPs, usually offered in conjunction with a health savings account, are growing in use in the United States. Dr. Dubois notes that while premiums may be lower in HDHPs, they feature higher deductibles that must be met before traditional medical and pharmacy coverage begins. For many consumers, meeting the deductible—which can run several thousands of dollars—can be a sizable portion of their incomes. Placing more of the economic burden on consumers can reduce unnecessary or excess health care, but it also can reduce appropriate or needed care.

In his commentary, Dr. Dubois points to research that shows lowering cost sharing for certain treatments or covered preventive care before the deductible, particularly for chronic conditions, can improve medication adherence and keep employees healthier. Encouraging access to higher value care through value-based insurance design and capping out-of-pocket costs for copays and coinsurance are other methods that are being utilized to reduce the burden on consumers.

Dr. Dubois explains, “It is important to reduce barriers that can hamper patient access to care, especially when we know that medication adherence and access to higher value care can make a big difference in reducing costs for both patients and our health care system.”

Read the full column on the AJPB website.