FICO’s Medication Adherence Score

June 22, 2022 - By Deb Linton

You’ve heard of a FICO Credit Score. Now introducing: FICO’s Medication Adherence Score. Please read the New York Times Keeping Score on How You Take Your Medication and pay even closer attention to the comments it’s collecting.

Advancements in pharmacology have dramatically changed the way we approach care. Conditions with treatments formerly relegated to hospitalization have now become manageable but depend heavily on adherence to care regiments that include everything from medication and physical therapy to significant changes in nutrition and behavior. As treatments have become more refined, providers are better able pursue massive cost saving objectives like reducing readmission and new types of preventative care. These approaches have also provided patients the opportunity to participate and influence their own care like never before. However, while these trends have been known for a while, there hasn’t been a broadly accepted way to measure adherence or how a patient might affect the outcome of their own care. FICO’s Medication Adherence Score could change that.

One way to look at the introduction of such a score is that, patients are the most underutilized resource in the health system and Medication Adherence FICO Score could provide a tool to engage patients and quantify their participation. FICO officials say insurance companies and other health care groups will use the score to identify those patients who could benefit the most from follow-up phone calls, letters and e-mails to encourage proper use of medication. Unfortunately, such a broad sweeping metric runs the risk of misapplication and has left many skeptical about FICO’s future role in their care.

Questions have emerged around how FICO will extrapolate an individuals score, how insurers will use scores to profile those seeking coverage and what patients can do to improve their standing once “they’ve” been evaluated. People are also concerned about privacy and re-identification. Although FICO is HIPAA compliant, it’s unknown how, exactly, FICO is mashing your publicly available data to calculate a grade they can associate with you.

According to the article, “(t)he FICO medication score is based on publicly available data, like home ownership and job status, and does not rely on a patient’s medical history or financial information to predict whether he or she will take medication as directed. So, like a credit rating, it can be compiled without a person’s knowledge or permission.” In fact, you may already have a score. FICO said an estimated 2-3 million patients will have a FICO Medication Adherence Score by the end of the year and a total of 10 million patients are expected to be scored during the next 12 months. That timeline is, of course, dependent on FICO’s current negotiations with health care companies who plan to use the scoring system.