A Healthy Blog

Massachusetts health care — wonky, with a healthy dose of reality

Lower Copays Create Better Patient Outcomes

Lower Copays Create Better Patient Outcomes

December 5, 2011

A recent study from the New England Journal of Medicine indicates that the simple strategy of eliminating copayments may improve the quality of health outcomes for patients. The study, supported by the Commonwealth Fund, concludes that patients discharged from the hospital following myocardial infarction (heart attack) were more likely to take vital medications prescribed for their condition when copayments were waived. The patients with full coverage for their medications also experienced fewer heart attacks, strokes, and other vascular events during the study period, as compared with patients whose health plan coverage included cost-sharing for the same drugs.

The article reported that in addition to increasing patient adherence to medications and improving health outcomes, providing more generous prescription drug coverage produced no significant change in total spending for the insurer that took part in the trial. The authors call this intervention “a rarity in health care,” which “suggests that eliminating cost-sharing for secondary prevention after myocardial infarction may be cost-effective.”

For vulnerable populations in particular, increased cost-sharing for medications and services can have a negative impact on both health care outcomes and costs. That’s why Health Care For All and the ACT Coalition strongly support S. 517, An Act Relative to Coverage for Chronic Illness. This bill, sponsored by Senator Montigny, eliminates co-payments for all prescriptions and devices used for the treatment of chronic illness. When individuals forgo taking essential drugs because they cannot afford to pay for them, this not only compromises health outcomes but may result in the need for costly emergency department treatment and increased hospitalizations.

Because relatively small co-payments have likewise been associated with lower rates of seeking preventive services, Health Care For All also strongly support S. 511, An Act to Encourage Preventive Care, sponsored by Senator Jehlen. This critical bill would break down barriers to care by eliminating co-pays for preventive services for low and moderate income individuals who have Commonwealth Care coverage.  As outlined in the ACT Coalition testimony, we recognize that preventive care helps people live healthier, more productive lives and reduces costs by preventing or catching and treating health problems early.

The elimination of copayments for prescriptions used to treat chronic illness and for preventative services would be a significant step forward in improving health outcomes and decreasing long term health care costs in Massachusetts.  We’ve seen the evidence that these simple interventions work; now it’s time to take action.
-Alyssa Vangeli