The health policy cows are back for April’s report, which presents data and opinions regarding the need to pilot-test implementing managed care in the Medicare arena in a similar manner as typically occurs in Medicaid — mandatory enrollment of beneficiaries into a small number of competitively selected MCOs.
Over 90 percent of Louisiana’s Medicaid prescriptions are paid for by MCOs. The Louisiana Association of Health Plans engaged us to assess the impacts of a potential policy change to take the preferred drug list (PDL) content responsibility away from the Medicaid MCOs and shift it to a single state-administered and state-determined PDL. Our key finding is that this policy change would be costly to the State and its taxpayers – increasing overall annual Medicaid costs by $40 million and increasing annual State Fund expenditures by approximately $15 million. Our report provides evidence across dozens of states demonstrating that a focus on optimal management of Medicaid’s drug mix at the “front end” produces more favorable net costs than an approach that relies primarily on “back end” rebate maximization.
The Legislative Budget and Audit Committee of Alaska sought information and analyses with regard to other states’ experiences with Medicaid reform and expansion initiatives. This report describes opportunities for Medicaid savings and to reduce pharmacy costs. As well as recommendations for contracting, incorporating employment supports, improving and monitoring access to care, and reducing unnecessary emergency department utilization.