HEALTH

Cost of health care on the rise

BY Michael Johnsen

WASHINGTON Workers on average are paying nearly $4,000 this year toward the cost of family health coverage — an increase of 14%, or $482, above what they paid last year, according to the benchmark "2010 Employer Health Benefits Survey" released Thursday by the Kaiser Family Foundation and the Health Research and Educational Trust.

The jump occurred even though the total premiums for family coverage, including what employers themselves contribute, rose a modest 3% to $13,770 on average in 2010, the survey found. In contrast, the amount employers contributed for family coverage did not increase.

 

Since 2005, workers’ contributions to premiums have gone up 47%, while overall premiums rose 27%, wages increased 18% and inflation rose 12%.

 

 

Many employers also are raising the annual deductibles workers must pay before their health plans begin to share most healthcare costs. A total of 27% of covered workers now face annual deductibles of at least $1,000, up from 22% in 2009, the survey found. Among small firms (three to 199 workers), 46% face such deductibles.

 

 

“With the economy struggling, businesses have been shifting more of the costs of health insurance to workers through premiums, deductibles and other cost-sharing,” Kaiser president and CEO Drew Altman stated. “This may be helping to stem the rapid rise in premiums that we saw in the early 2000s, but it also means employer coverage is less comprehensive. From a consumer perspective, the cost of health insurance just keeps going up faster than wages.”

 

 

“High out-of-pocket expenses and premiums affect healthcare decisions for patients," added Maulik Joshi, president of the Health Research and Educational Trust and SVP research at the American Hospital Association. "If premiums and costs continue to be shifted to consumers, households will face difficult choices, like forgoing needed care, or reexamining how they can best care for their families,”

 

 

The nation’s recession contributed to the shift in burden to workers. In response to the economic downturn, 30% of employers said they reduced the scope of health benefits or increased cost sharing, and 23% reported increasing the amount employees pay for coverage, the survey found.

 

 

Among other plan types, only such consumer-driven plans as a health savings account, which allows for the reimbursable purchase of over-the-counter medicines in addition to prescriptions and other healthcare services, saw growth in their market share. Such plans now enroll 13% of covered workers, up from 8% last year.

 

 

“Consumer-driven plans have clearly established a foothold in the employer market, tripling their market share from 4% in 2006 to 13% today,” said study lead author Gary Claxton, a Kaiser VP and director of the Healthcare Marketplace Project.

 

 

About three-fourths (74%) of employers offering health benefits offered at least one of the following wellness programs: weight-loss program; gym membership discounts or on-site exercise facilities; smoking-cessation program; personal health coaching; classes in nutrition or healthy living; Web-based resources for healthy living; or a wellness newsletter.

 

Also among firms offering coverage, 11% gave their employees the option of completing a health risk assessment to help employees identify potential health risks. Within this group, 22% (2% of all employers) offer such financial incentives as lowering the worker’s share of premiums or offering merchandise, gift cards, travel or cash to their workers. Large firms are more likely than small firms both to offer assessments and to offer financial incentives.

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‘Multifaceted strategies’ can improve medication adherence among patients

BY Alaric DeArment

SAN DIEGO Improving medication adherence will require bringing multiple methods together in order to be successful, Pharmacy Quality Alliance senior director for research and performance measurement David Nau said Tuesday in an education session at the National Association of Chain Drug Stores’ Pharmacy and Technology Conference in San Diego.

 

“You need to have a multifaceted strategy around adherence if you want to have an impact on adherence,” Nau said.

 

 

According to last year’s study by the New England Healthcare Institute, poor medication adherence increases medical costs by up to $290 billion. The estimated one-third of patients who do not take their medications properly fail to do so for a number of reasons, which Nau boiled down to five social-economic, patient-related, therapy-related, condition-related and healthcare system-related factors, including costs of medications, fear of side effects and dependence, complexity of regimens, comorbidities and lack of incentives.

 

 

Complexity of medication regimens can be a particular problem for patients with chronic conditions. According to a study of patients using statins for cardiovascular disease, the average user studied took 11 medications, including nine maintenance medications, and often had to visit multiple pharmacies and had multiple prescribers; 10% of statin users studied took 23 or more medications. But according to another study, conducted by Harvard University and CVS Caremark, patients demonstrated greater adherence when they synchronized their refills and were able to fill all their prescriptions at one pharmacy.

 

 

All these factors mean that combating nonadherence requires a number of different approaches rather than simple interventions, Nau said. “It’s not just about counseling; it’s not just about slashing co-pays — it’s about having a multifaceted strategy,” he said.

 

 

Future trends that could affect adherence include deals between drug companies and pharmacy benefit managers, integration of medication reminders into social networking sites and medication-delivery technologies allowing delivery of multiple drugs in one pill, or implants that automatically administer doses. The last trend already is under way, to an extent, with the introduction of combination drugs for hypertension, such as Novartis’ Tekamlo (aliskiren and amlodipine besylate), which the Food and Drug Administration approved in late August.

 

 

Following Nau’s presentation, Rite Aid director of clinical services Rick Mohall took the stage to show some of the retail pharmacy chain’s adherence programs, such as automatic refills, reminder calls, medication therapy management and the Wellness+ rewards card. “Generally, what’s good for the patient is good for the pharmacy as a business,” Mohall said.

 

 

Both presenters emphasized the role of pharmacists in solving the nonadherence problem, with Nau citing a study from this year showing that physicians are “rather ineffective” in promoting medication adherence. “The greatest intervention tool, the thing that all these things need to point to, is the pharmacist,” Nau said.

 

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Walgreens to acquire assets of 18 ApothecaryRx pharmacies

BY Allison Cerra

DEERFIELD, Ill. Walgreens has reached a definitive agreement with Graymark Healthcare to acquire the company’s assets of 18 retail pharmacies across five states.

Graymark Healthcare’s subsidiary, ApothecaryRx, is an independent retail pharmacy business. Affected ApothecaryRx patients in Colorado, Oklahoma, Minnesota, Missouri and Illinois will be notified upon the transaction’s closing. The deal is expected to close in fourth quarter 2010, Walgreens said.

“We have a long history of providing high quality pharmacy services in these markets,” said Walgreens operations VP Bill Miller. “Our staff is dedicated to making the transition as seamless as possible for our new customers. We look forward to introducing them to the unique offerings that have made Walgreens one of the country’s most trusted providers of pharmacy, health and wellness services and daily living needs.”

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