Jayoung Han1, Yiran Zhang2, Gina No3, Julie Urmie4. 1. School of Pharmacy and Health Sciences, Fairleigh Dickinson University, USA. Electronic address: jayoung@fdu.edu. 2. Department of Pharmacotherapy and Outcomes Science, School of Pharmacy, Virginia Commonwealth University, USA. 3. School of Pharmacy and Health Sciences, Fairleigh Dickinson University, USA. 4. Division of Health Services Research, Department of Pharmacy Practice and Science, University of Iowa, USA.
Abstract
BACKGROUND: People with incomes below the Federal Poverty Level (FPL) do not qualify for health insurance subsidies and may not be eligible for Medicaid. Patients in this Medicaid Coverage Gap may have difficulty paying for their medications. OBJECTIVE: To estimate medication adherence and the prevalence of underinsurance among chronic condition patients in the Medicaid Coverage Gap. METHODS: A retrospective cohort study was conducted using 2014-2016 data extracted from the Medical Expenditure Panel Survey. The sample included non-elderly patients with prescription fills (≥2) for at least one of five chronic conditions (hypertension, hyperlipidemia, diabetes, depression and anxiety disorder) and income below the FPL. Medication adherence was measured using Medication Possession Ratio (MPR), and adjusted using patient demographics, health conditions, and health care utilization. The prevalence of underinsurance also was examined. RESULTS: Of the 316 patients, 60.4% were female, with an average age of 50, and an average of 3 health conditions. The weighted MPR was 72.0% and 44.6% had an adjusted MRP ≥80%. Nearly 80% of the patients were either continuously uninsured (21.6%) or underinsured (59.0%). CONCLUSIONS: A significant proportion of chronic condition patients in Medicaid Coverage Gap were underinsured and less than half were adherent to their medications.
BACKGROUND:People with incomes below the Federal Poverty Level (FPL) do not qualify for health insurance subsidies and may not be eligible for Medicaid. Patients in this Medicaid Coverage Gap may have difficulty paying for their medications. OBJECTIVE: To estimate medication adherence and the prevalence of underinsurance among chronic condition patients in the Medicaid Coverage Gap. METHODS: A retrospective cohort study was conducted using 2014-2016 data extracted from the Medical Expenditure Panel Survey. The sample included non-elderly patients with prescription fills (≥2) for at least one of five chronic conditions (hypertension, hyperlipidemia, diabetes, depression and anxiety disorder) and income below the FPL. Medication adherence was measured using Medication Possession Ratio (MPR), and adjusted using patient demographics, health conditions, and health care utilization. The prevalence of underinsurance also was examined. RESULTS: Of the 316 patients, 60.4% were female, with an average age of 50, and an average of 3 health conditions. The weighted MPR was 72.0% and 44.6% had an adjusted MRP ≥80%. Nearly 80% of the patients were either continuously uninsured (21.6%) or underinsured (59.0%). CONCLUSIONS: A significant proportion of chronic condition patients in Medicaid Coverage Gap were underinsured and less than half were adherent to their medications.
Authors: Heather Angier; Nathalie Huguet; David Ezekiel-Herrera; Miguel Marino; Teresa Schmidt; Beverly B Green; Jennifer E DeVoe Journal: Fam Med Community Health Date: 2020-12