- Center on Health Equity & Access
- Clinical
- Health Care Cost
- Health Care Delivery
- Insurance
- Policy
- Technology
- Value-Based Care
Exchange Plans Pose More Prescription-Use Barriers
Patients covered by exchange-based insurance are more likely than those in employer-sponsored plans to face utilization management controls-such as prior authorization and step therapy-in filling their prescriptions, a report Monday from healthcare consultancy Avalere Health contends.
Patients covered by exchange-based insurance are more likely than those in employer-sponsored plans to face utilization management controls—such as prior authorization and step therapy—in filling their prescriptions, a report Monday from healthcare consultancy Avalere Health contends.
In the mental health category, 50% of drugs were covered without utilization management in employer-sponsored plans versus 15% in exchange-based plans, according to Avalere's data. Also, 27% of oncology drugs were covered without utilization management in employer-sponsored plans, compared with 16% in exchange-based plans. The majority of HIV/AIDS drugs—60%—were covered free of utilization management in exchange-based plans, but that number still paled in comparison to patients with employer-sponsored insurance.
Read the full story here: http://bit.ly/1ljylXl
Source: Modern Healthcare
