Even though more Americans are insured than ever before, many are facing insurance barriers that may interfere with a doctor’s prescribed course of treatment and impact their care. We recently examined how improving access to out-of-pocket cost information is one policy solution that can help engage and empower patients to make more informed choices about their coverage.
Another policy solution is to improve access to information about medication restrictions and the clinical information used to establish them. Our new video looks at some of the ways insurers incentivize or discourage the use of specific medicines or services a doctor prescribes before providing coverage, such as step therapy and prior authorization. These practices, known as utilization management, sometimes delay access to treatment and negatively impact overall health, so it’s important for consumers to be mindful of such barriers.
Navigating health insurance coverage can be complicated, but with the right information, consumers can make more informed decisions about their care. Check out our other videos in the Coverage Classroom, and learn about more solutions to engage and empower consumers at AccessBetterCoverage.org.
Allyson Funk Ally is a former senior director of public affairs at PhRMA focused on advocacy issues for the biopharmaceutical industry. Her expertise includes Medicare, Medicaid, 340B, health reform and more. Prior to PhRMA, her experience included leading health communications for a large membership organization, supporting public affairs clients and working for the governor of Louisiana.