AlignMap In Cites

Strategies to Improve Medication Compliance by Medicare Beneficiaries — Wilensky 117 (10): 1252 — Circulation Quote derives from an editorial on the article referenced in the preceding AlignMap In Cites post. The author of the editorial (an economist) concludes “Low copayments for medically appropriate therapeutics are a fundamental part of value-based insurance. I support the concept. However, pressing for full coverage for specific pharmacotherapy classes on a disease-by-disease basis is not likely to be an effective way to fix the current program. The question is how to best move the current, fragmented, stove-piped system that characterizes Medicare to one that rewards physicians and institutions that provide high-quality cost-effective care to patients.”

I emphasize this conclusion because it is in keeping with my long held, redundantly reiterated stance that piecemeal attempts to enhance treatment adherence are not only intrinsically limited by the scope of that area of noncompliance but also because changes in one area of the healthcare system are likely to have unintended consequences elsewhere in the system that may reduce or even reverse whatever advantages the initial change might have wrought.

My only criticism of the editorial, in fact, is that its focus is restricted to healthcare needs of seniors and Medicare, which is yet another reiteration of the same problem of addressing the compliance issue piecemeal - only with larger pieces.