What’s your Health Credit Score?

We all know about the FICO credit score, the metric used by banks to determine our credit worthiness and ability to obtain mortgages and credit cards. Many people regard this score as sacrosanct, knowing that the higher one’s score, the more valuable they are to lenders and the better the reflection on their financial character and responsibility.

In 2011, the same company came out with a new score – the FICO Medication Adherence Score. Basically, the score measures patient drug adherence by analyzing prescription refill rates as well as other data, such as diagnosis codes. The data is obtained from the large pharmacy chains. Ultimately, FICO will know if you are taking your medication on time, skipping doses or taking too much, based upon how often you refill the prescription (or don’t fill it at all).

One potential area of concern is that they may combine this data with other sources, such as a patient’s affinity card data – like your grocery club card. This could prompt your score to be lowered should the model deem you to be riskier due to unhealthy food purchases, for example. They could potentially also combine it with other publically available, newer data sources, such as voluntarily provided patient generated health data (e.g., fitness data). With so much big data out there, this score’s algorithm could take many directions.

Critics of the score also point out that adherence may not necessarily be the issue when not filling a prescription. Oftentimes, cost comes into play and many patients don’t have the idea or assertiveness to discuss other treatment options with their physician that may suit their budget better. Yet, their score will be affected should they not continue on the expensive prescribed drug.

Why is this score important now, when we are all guaranteed insurance under the Affordable Care Act? Well, the score could ultimately play into the rates payers charge us. The lower your score, the more your insurance may cost you. Payers may use it as an indicator of how expensive you may be to the health system.

Additionally, employers could use this in hiring and firing decisions as well: which employee’s health care is going to cost them more in the long run?

Finally, pharmaceutical companies are interested in this data as well. By knowing drug adherence metrics, they can design marketing programs geared towards populations with low scores. By boosting prescription refills, they ultimately profit.

So, many parties are interested in this new metric. Time will tell how it will be used and the level of impact. Yet, many of us don’t even know it exists – something to think about the next time your doctor writes you a prescription.