New analysis suggests the exchanges didn't provide enoughinformation on drug coverages or providers for consumers to make anadequate—or at least hassle-free—decision.

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A report from Avalere Health finds that drug coverageinformation was often elusive and confusing for consumers shoppingon the exchanges, highlighting another challenge for the exchangesunder the Patient Protection and Affordable Care Act.

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In nearly half of the plans analyzed by the consulting firm, itwas difficult or impossible for people to determine what drugs werecovered. Specifically, 38 percent of plans had no drug formularydata available, “presenting significant obstacles to consumers whoare shopping for insurance and attempting to assess the value oftheir coverage.” In 11 percent of cases, finding covered drugs was“difficult” or “very difficult.”

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Though provider information was more accessible than druginformation, it was still nearly impossible for a consumer to finda doctor almost a quarter of the time. Provider information was notavailable in 16 percent of cases, and “difficult” or “verydifficult” 7 percent of the time.

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The consulting firm is among the first to analyze the consumerexperience on the exchanges post-enrollment. They analyzed 85 planssold in five states via HealthCare.gov and through 12 states-basedexchange websites.

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Consumers typically were forced to search—oftenunsuccessfully—carrier websites for drug information, AvalereHealth said.

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“HealthCare.gov and several other state websites—includingColorado, Connecticut, Maryland, Minnesota, Nevada and NewYork—include a link to formularies and provider directories foreach plan,” Avalere Health researchers said. “However, the linksare not always direct, and in some cases, these links may redirectconsumers to the insurer's homepage, which requires consumers tonavigate the website, with as many as six clicks, to find theappropriate documents.”

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California has the only website that offers consumers a roughout-of-pocket calculator to help gauge expected costs by exchangeplan, their research found. Nevada was the only website thatincludes a drug search function that shows how a person's drug iscovered by every plan on the exchange.

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Avalere Health Vice President Caroline Pearson said she hopesthe noted exchange flaws identified in the report will spur changesin future enrollment to improve transparency and the overallconsumer experience.

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“Providing understandable and accessible information about theproviders and drugs included in exchange plans is essential tohelping enrollees make informed purchasing decisions that balancepremium against scope of coverage,” Pearson said.

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