Association Between Cost-Related Delay in Filling Prescriptions and Health Care Ratings among Medicare Advantage Recipients

Abstract

Patients with lower socioeconomic status frequently report not filling or delaying prescription medications due to cost (hereafter, cost-related prescription delay, CRPD). We hypothesized that CRDP would be associated with lower medical care ratings, but the effect would be confounded by socioeconomic and health factors. In the 2012 CAHPS Medicare Advantage Survey, recipients were asked to rate their medical care while reporting if they had experienced CRPD in the past 6 months. CRPD more than doubled the relative risk (RR) for poor ratings of personal doctor (RR 2.34), specialist (RR 2.14), and overall health care in the past 6 months (RR 2.40). Adjusting for sociodemographic and health status slightly reduced the RR to 1.9, but adjusting for low income subsidy and lack insurance for medications did not. Our results show that CRDP is independently associated with poor ratings of medical care irrespective of health, financial, or insurance status. Providers might improve patient ratings and thus satisfaction by explicitly discussing prescription cost and mutually forming affordable treatment plans.