Tuesday, December 1, 2015

Newly Insured under Obamacare and Chronically Ill

Open enrollment may have just ended, but preliminary data on health care utilization is already beginning to trickle in. Although the numbers are bound to change with time, it appears that those who are already making use of their new marketplace coverage are sicker than average. And that's not bad news.

Newly Insured under Obamacare and Chronically Ill


Open enrollment may have just ended, but preliminary data on health care utilization is already beginning to trickle in.  Although the numbers are bound to change with time, it appears that those who are already making use of their new marketplace coverage are sicker than average.  And that’s not bad news.

The US has consistently spent more on health care per capita than other high-income countries in return for higher infant mortality rates and shorter life expectancies.  Obamacare was passed in an attempt to halt this trend and improve the cost, access, and quality of the nation’s healthcare.  Or more concretely, to stop the healthy from getting sick, and the sick from getting sicker.

A study just released by Express Scripts—the nation’s largest pharmacy benefit management company, indicates that Obamacare may be achieving this concrete goal.  In January and February of this year, those who were newly insured through a marketplace plan bought more specialty medication than the commercially insured. Such medication tends to be more expensive because it treats chronic conditions with limited treatment options such as HIV/AIDS or Hepatitis C.  The rate of purchase of pain, depression, and seizure medication was also higher among marketplace enrollees.

So why is more spending something to celebrate? 

More coverage

Obamacare increased access to coverage to those who were uninsured because of a pre-existing condition, cost, or both.  By eliminating these barriers, the sick were potentially among the most motivated to deal with the healthcare.gov technical difficulties.  This data now demonstrates that those who obtained coverage are also seeking treatment, possibly slowing our overall healthcare spending through disease management.

The Express Scripts data provides a crude overview of health care utilizers, but it may be the beginning of a trend that shows Obamacare to be a good return on investment.

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Robert I. Field, Ph.D., J.D., M.P.H. Professor, Drexel University Kline School of Law & Dornsife School of Public Health
Jeffrey Brenner, MD Founder of the Camden Coalition of Healthcare Providers, Medical Director of the Urban Health Institute at Cooper University Healthcare
Andy Carter President & CEO, The Hospital & Healthsystem Assoc. of Pa.
Robert B. Doherty Senior Vice President of Governmental Affairs & Public Policy American College of Physicians
David Grande, MD, MPA Assistant Professor of Medicine at the University of Pennsylvania
Tine Hansen-Turton Chief Strategy Officer of Public Health Management Corporation
Drew A. Harris, DPM, MPH Director of Health Policy Program at the Jefferson College of Population Health
Antoinette Kraus Director of the Pennsylvania Health Access Network
Laval Miller-Wilson Executive Director of the Pennsylvania Health Law Project
David B. Nash, MD, MBA Founding Dean of the Jefferson College of Population Health
Mark V. Pauly, Ph.D. Professor of Health Care Management, Business Economics and Public Policy at The Wharton School
Howard J. Peterson, MHA Managing Partner of TRG Healthcare, a national healthcare consulting firm
Paula L. Stillman, MD, MBA Healthcare consultant with special expertise in population health and disease management
Elizabeth A. W. Williams Senior Vice President & Chief Communications Officer for Independence Blue Cross
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