Older couple looking at papers with laptop open; uninsured patients concept

How To Help Uninsured Patients Find Financing Using Data

Millions of U.S. patients remain uninsured or underinsured, creating a barrier to access for their needed medications.

By collecting and analyzing data during the patient journey, providers, pharmacies and pharmaceutical manufacturers can better understand why uninsured patients struggle to get their medications — and intervene effectively.

The Uninsured Patient Population

The first step in using data to bolster uninsured patients’ efforts to acquire needed specialty drugs is to consider the scope of the problem.

While the number of patients in the U.S. without health insurance has declined in recent years, coverage remains an issue for millions. In 2021, 28 states reported lower uninsured rates than in 2019, according to researchers Douglas Conway and Laryssa Mykyta at the U.S. Census Bureau. Only one state, North Dakota, reported that uninsured rates had risen between 2019 and 2021.

Nationwide, the uninsured rate dropped to about 8 percent in 2022, an all-time low, writes AP reporter Amanda Seitz. Yet this eight percent isn’t spread proportionally across the American population.

Working-age adults between ages 18 and 64 are disproportionately likely to be without healthcare coverage, write researchers Amy E. Cha and Robin A. Cohen. Education level, racial and ethnic origin, and family income levels also affected individuals’ likelihoods of going without health insurance.

Even those who have health insurance may not have adequate coverage. Commonwealth Fund researchers Sara R. Collins, Lauren A. Haynes and Relebohile Masitha surveyed 8,022 U.S. adults over age 18. Among the respondents under age 65, the researchers found that:

  • 43 percent of working-age adults had inadequate healthcare coverage in 2022.
  • 11 percent of these had a coverage gap over the past year.
  • 23 percent of these had health insurance, but it didn’t provide them with affordable access to care due to high deductibles, carve-outs and other policy limitations.

Nearly half (46 percent) of the survey respondents said they skipped or delayed medical care due to costs, while 49 percent said they lacked the resources to pay an unexpected $1,000 medical bill should it appear. Among low-income, Black, and Latinx adults, these percentages were even higher.

As the numbers indicate, lack of insurance remains a problem for patients — including patients who need specialty medications for rare diseases. Leveraging data is one way to help solve this problem.

Older man looking at tablet shown to him by a smiling healthcare professional; uninsured patients concept

How Data Helps Connect Uninsured Patients to Financial Help

Uninsured patients may run into any number of barriers while seeking access to needed medications. For example:

  • Patients may be unable to afford medication.
  • Patients may be unable to access more affordable options. For many specialty medications, for instance, no generic form is available. Some specialty medications cannot be shipped through bulk delivery programs, eliminating patients’ opportunity to take advantage of bulk purchase savings.
  • Drug assistance or drug replacement programs may provide only partial help — if these programs are available at all.
  • Patients may not know that less costly sources for their medications, such as specialty pharmacies, are available.
  • Patients may not realize they qualify for Medicaid or another program that would provide coverage or otherwise lower the costs of their medications.

Each of these hurdles requires a different approach to clear. The question for healthcare providers, pharmacies and drug manufacturers: Which of these reasons applies for any given patient?

Data collection allows participants to answer this question. When patients connect with providers, pharmacies and funding sources through a single digital platform, they provide data that can give a clearer picture of their particular situation.

Connecting patients to the specialty medications they need becomes easier when data analysis spots patterns and responds accordingly.

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