So Simple, So Hard tackles adherence challenges in CA – National Consumers League

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“So Simple, So Hard” was the theme of the medication adherence conference the National Consumers League (NCL) held on September 15 in Sacramento, California. Sponsored by the Agency for Healthcare Research and Quality (AHRQ), the speakers and attendees explored the challenges and barriers to medication adherence – why it is so hard – and highlighted the tools and strategies to make it simpler and to improve adherence and health outcomes, especially among underserved populations.

NCL gathered more than 80 stakeholders in Sacramento, including health care professionals, community health workers, advocates, industry representatives, policymakers, and researchers. Throughout the day, conference participants heard from researchers and experts on adherence, and engaged with each other about possible collaborations and solutions.

The meeting kicked off with presentations on adherence research and health disparities, and continued with a variety of strategies and tools to improve adherence that could be utilized in health care practices or organizations. Takeaways from the presentations included the following:

  • One size does not fit all – adherence intervention work best when tailored for the patient
  • Quality of communication and a sense of collaboration between patients and health care professionals impact adherence, especially among people of color   
  • Adherence rates are unique to each medication a patient takes 
  • Cultural considerations are vital to understanding barriers to adherence
  • Always consider the health literacy of the patient
  • Determining the reasons for poor adherence is essential to developing effective interventions   

Specific strategies and solutions:

  • Medication synchronization
  • Comprehensive medication review
  • Tools for translating medication labels into the patient’s native language
  • Best practices and tools for more culturally competent clinical care

The conference provided a forum for participants to interact, connect, and lay the groundwork to develop partnerships for collaborative initiatives. We will be following up with all conference participants to determine the benefits of the conference and learn of any connections and /or collaborations developed.  

At NCL, we view poor adherence, with its devastating effect on health outcomes, as a public health problem. Since 2011, we have been leading Script Your Future – a public education campaign to increase awareness among patients, their family caregivers, and health care professionals of the importance of taking medication as directed.

As leaders of Script Your Future, NCL convened an AHRQ research dissemination conference to further explore possible solutions to this public health problem. The adherence issue is complex and taking medications is NOT so simple, especially for ethnic and racial minorities who often face health disparities. Collaboration among stakeholders who are dedicated to keeping the patient at the center of the discussion, is a critical first step toward developing and implementing effective medication adherence strategies to help people better self-manage their care.  

Conference participants and others are encouraged to distribute information from the conference to interested colleagues and through their networks. We look forward to hearing how others are sharing the information, tools, and resources from the conference, and the possible collaborations that will grow out of the meeting.   

* Funding for this conference was made possible in part by grant number 1R13HS023948-01A1 from the Agency for Healthcare Research and Quality (AHRQ). The views expressed in written conference materials or publications and by speakers and moderators do not necessarily reflect the official policies of the Department of Health and Human Services; nor does mention of trade names, commercial practices, or organizations imply endorsement by the U.S. Government

A Big Win For California Patients And Consumers – “Refill Reminders” A “Go” – National Consumers League

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sg.jpgCalifornia’s Office of Health Information Integrity (CalOHII) just delivered a big victory for patients and consumers by expressly recognizing that sponsored medication adherence programs for a currently prescribed drug (commonly called “refill reminders”) do not require patient authorization in California. In publishing its long-awaited State Health Information Policy Manual, CalOHII takes a step to harmonize the state’s Confidentiality of Medical Information Act (CMIA) with the federal medical privacy laws and regulations (a.k.a., the HIPAA Privacy Rule).

For years now, due in part to privacy concerns, confusion has persisted within the healthcare community about the types of refill reminder programs that can legally run in California. In fact, California is the only state in the U.S. where pharmacies do not, to any meaningful degree, operate sponsored refill reminder programs. California consumers deserve the benefit of refill reminders that provide helpful information to patients about their prescription drugs. Patient access to this information is now guaranteed.

CalOHII’s publication of its Manual makes clear that California adopts the same approach that the U.S. Department of Health and Human Services (HHS) took in its 2013 final rulemaking and “Refill Reminder Guidance.” Under that HHS Guidance, pharmacies are able to provide their patients with sponsored refill reminders. NCL applauds CalOHII for clarifying that the CMIA should be interpreted consistently with the HIPAA Privacy Rule. With that clarification, NCL is hopeful that California pharmacies and their sponsors will jumpstart sponsored refill reminder programs. 

NCL is a longstanding supporter of refill reminder programs. NCL leads  “Script Your Future,” a public education campaign designed to raise awareness of the importance of taking medication as prescribed. Poor medication adherence is a major, and significantly under-appreciated, health problem. Studies establish that nearly three-out-of-four Americans do not take their medications as directed, which costs the healthcare system nearly $300 billion per year and results in almost 125,000 unnecessary deaths per year. To help combat this problem, most pharmacies, health plans, and doctors provide a broad range of patient-directed communications regarding prescription drug therapies, including communications that encourage patients to stay on prescribed therapy. The sponsored refill reminder programs endorsed by CalOHII in its Manual are a key part of these efforts in California.  

 As a founding member of the Best Privacy Practices Coalition, NCL is also a strong believer in the protection of medical privacy. However, medical privacy does not exist in a vacuum. NCL is pleased that CalOHII has arrived at a great middle ground that balances the need for information with privacy concerns of patients. This balance is a win for Californians.

King v. Burwell ruling will keep consumers insured (and healthy!)

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Health_Care_Law.jpgThe King v. Burwell ruling in favor of the Affordable Care Act (ACA) has allowed for approximately eight million consumers to keep their insurance coverage. In the King case, petitioners challenged the clause of the Affordable Care Act that stated subsidies are available to people who use an exchange “established by the State” to purchase insurance. 

Consumers living in the 34 states without state marketplaces are able to benefit from the subsidies because the Internal Revenue Service allowed people to receive assistance if they purchased a plan on the federally-run marketplace. The plaintiffs argued that subsidies by law are only given to people living in states with their own health insurance marketplaces. The ruling allows consumers in states where the marketplace is run by the federal government to keep their subsidy and insurance.

The National Consumers League (NCL) applauds the Supreme Court for upholding the ACA subsidies for consumers using the federal marketplace. The Supreme Court decision helps prevent a rise in premiums for all consumers using the health care exchange. The subsidies are a key provision of the law and they are an important part of keeping consumers insured and healthy. This decision provides hope that the ACA will face fewer political and legal obstacles in the future and can continue to provide health insurance to consumers. Despite the naysayers, the numbers speak volumes. Since the ACA’s enactment, more than 16 million Americans have been able to afford quality health insurance they did not have before.

If you do not already have health insurance, you can enroll in person, over the phone, by mail, online at Healthcare.gov, or on your state exchange’s site during the open enrollment period.