With the second Affordable Care Act Health Insurance Marketplace open enrollment period opening tomorrow, CVS Health has released new data examining early numbers for prescription drug utilization by patients newly-insured through the ACA. The analysis looks at aggregate insurance claims from between January to September of this year for plans managed by CVS Health, and compares it to ACA plan members with commercial health plans and managed Medicaid plan members.
The conclusions? Those that enrolled in ACA coverage were slightly older than those in the commercial market (average age of 42 compared to 37), but prescription drug utilization was practically identical. Around one-third of patients in exchange plans filled prescriptions using their insurance, with a generic dispensation rate of 88%—a higher rate than that in commercial and managed Medicaid plans.
Newly-insured patients with marketplace plans were also more likely to have either HIV or Hep C, pushing up the utilization rate of specialty meds amongst this group. And although the amount of specialty med use was low across all the exchange plans, they accounted for 36% of drug costs in marketplace plans, 28% in commercial plans and 30% in managed Medicaid plans.
CVS will also partner with several health insurers who are participating in the marketplaces to provide on-site education events for consumers during the open enrollment period. The outreach will include brochure displays in CVS stores, educational materials online. 800 Project Health events will offer free screenings on-site between November and the close of the enrollment period in February, as well as the opportunity to communicate on an individual basis with insurance advisers.
Here are the biggest stories in the healthcare industry this week:
After talks with trade union IG Metall, Siemens has agreed to change course and keep its healthcare unit as part of its core portfolio.
The attorney general's office will investigate the closure, which will mean huge losses for owner Steward Health Care System.
Over-bedding is not the real problem, according to some researchers.
The new initiative is headed by Steven Thompson, founding CEO of Johns Hopkins International.
The kiosks could provide a meaningful challenge to retail clinics.
And here's what we were reading:
- An interesting study by the Robert Wood Johnson Foundation and the Urban Institute looked at what made some federally-facilitated marketplace states more successful at ACA enrollment than others.
- SCOTUSblog unveiled seven myths about King v. Burwell.
- Jeffrey Young offers advice to consumers on how to avoid paying more for ACA coverage in 2015 in the Huffington Post.