WASHINGTON, Aug. 10, 2011 /PRNewswire-USNewswire/ — In a
just-released National Minority Quality Forum Issue Brief
(Specialty Tiering: Unequal Treatment http://www.nmqf.org/IB3SpecialtyTiersFinal.pdf
), Gary Puckrein and Gretchen Wartman examine specialty
tiering, which has become popular among insurers (public and
private) as a benefit-management tool to limit their financial
exposure by requiring beneficiaries to pay more for certain
high-cost prescription drugs. The authors remind us that, the
Institute of Medicine cautioned in 2003: “Aspects of health
systems—such as the ways in which systems are organized and
financed, and the availability of services—may exert
different effects on patient care, particularly for racial and
ethnic minorities” (Brian D. Smedley,
Adrienne Y. Stith, and Alan R. Nelson, eds.,
Unequal Treatment: Confronting Racial and Ethnic Disparities in
Health Care [Washington, DC: National Academies Press, 2003],
p. 8). Specialty tiering exerts different effects by design.
It chips away at the risk-pooling effects of insurance by shifting
a significant percentage of the cost of expensive medical
treatments to beneficiaries, possibly forcing the less affluent to
choose between paying for basic living expenses or taking their
medications. Cost shifting without means testing compromises access
to quality care and increases the potential for disparate and poor
health-care outcomes among minority populations, the financially
less able, beneficiaries with cancer or other complex diseases that
require expensive medical therapies, and those whose biologies may
cause them to metabolize drugs differently.
“We believe that this issue brief is quite timely,” explains
Dr. Puckrein, who is president and chief executive officer of
the National Minority Quality Forum. “The current economy not only
calls for creati
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