The Washington Post reported on August 4 that health and life insurance companies can cheaply and quickly get access to electronic prescription records of insurance applicants. At a cost of about $15 per request, private companies, including Milliman IntelliScript and Ingenix, will compile an insurance applicant’s prescription history from databases of past insurance claims. Both companies then analyze the data and generate an estimate of the applicant’s risk to the insurer. Applicants who take medication for expensive and/or chronic conditions are labeled high risk.
The compilation and analysis takes just a few minutes. Insurers can then use the information when deciding whether or not to insure a particular patient and at what price. In the past, insurers gathered health information on applicants from physician records, a much slower and more expensive undertaking that might not be comprehensive. In February the Federal Trade Commission ruled that electronic prescription records are subject to the same regulations as financial credit reports under the Fair Credit Reporting Act. Applicants who are denied health or life insurance based on their electronic prescription record must be given access to the record and the opportunity to correct errors.
Since psoriasis is chronic and often expensive to treat, especially for those who take biologics, psoriasis patients are likely to fare poorly in these electronic assessments of cost (which ignore the benefits of treatment entirely), making it even more difficult for self-employed psoriasis patients and others in the individual insurance market to secure affordable health insurance. Then again, insurers have always had methods for gathering pertinent health information about applicants; the new electronic services just make the process cheaper, faster, and easier. It remains to be seen how much effect the new methods will have on psoriasis patients who are seeking health insurance coverage. But it’s another troubling sign (like the emergence of Tier 4 Insurance Pricing) that insurance, which used to be about spreading risk among large groups of individuals, could one day be a place where only the healthy need apply.
Category: Health care system, Impact of psoriasis, Insurance, Public policy issues, Treatment
Tags: prescriptions
