New study focuses on improving Iowa healthcare exchange

The Partnership to Fight Chronic Disease (PFCD) released a public opinion poll of Iowa health care leaders and a new study analyzing the impact of increased cost sharing on patient adherence to prescription medications. The PFCD is a nationwide coalition working to educate policy makers and the public on the costs of chronic diseases. The research released at the Capitol was focused on how the Iowa healthcare exchange could be improved to help patients better understand their insurance options.

"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. 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 best address those issues to better serve every Iowan regardless of their health status," said author of the study and chairman of the PFCD Kenneth Thorpe, Ph.D. "By improving patient literacy within the exchange, we will improve health outcomes."

Dr. Thorpe's study, The Impact of Increased Cost Sharing on Patient Access and Prescription Drug Adherence found that when cost sharing in health insurance plans is higher some patients may forego their physician prescribed medications to save money. However, when patients skip medications their health status can decline which leads to a need for more invasive procedures and higher hospital costs. Based on the model utilized in the study, reductions in drug adherence by chronically ill patients could result in $106 million in increased hospital spending over the next 5 years.

"The consequences of Dr. Thorpe's study for Iowa patients with one or more chronic diseases as well as for health care spending in general is clear; lower cost sharing allows patients to maintain adherence to medication plans which decreases spending on invasive procedures and hospital stays," said Padmaja Ayyagari, assistant professor of health management and policy at the University of Iowa College of Public Health.

The PFCD also released a public opinion poll of Iowa health & community leaders which revealed that a majority of those familiar with the exchange marketplace had concerns. One major concern among was the clarity of information provided on the website—68 percent said information should be clearer and more detailed comparisons of the plans offered should be available.

"Iowa's opinion leaders had clear concerns about the user friendliness of Iowa's health exchange," said Candace DeMatteis, policy director at the Partnership to Fight Chronic Disease. "A high percentage of people polled agreed on some basic improvements that would make the website easier to navigate and insurance plans easier to compare. For example, 92 percent of those polled would require health plans to provide more comprehensive information about coverage and benefits available to patients."

The Leukemia and Lymphoma Society of Iowa, which is a member of the PFCD has been hearing similar concerns from patients who are trying to use the exchange.

"We were so glad to be able to work with the PFCD on this issue because patients need a better understanding of their options and the specific coverage and benefits included in each plan," said Christina Lee, director of government affairs for the Midwest region at the Leukemia and Lymphoma Society. "Blood cancer patients have a lot to worry about and choosing a health plan shouldn't be an ordeal. It should be a simple matter of comparing plans and choosing one that covers your preferred physicians and medications."

The Partnership to Fight Chronic Disease plans to work with local patients, policy makers and health groups in Iowa to help make improvements to the Iowa health exchange.

"We can make a few changes and really make a difference for chronically ill patients," said Dr. Thorpe, chairman of the PFCD. "Making the necessary changes is so important because it will lead to healthier patients, which will mean less health care spending."