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Medicaid Prescription Drug Management: Quality Scores Compared Across Different Approaches

Produced for: Elevance Health Public Policy Institute

The Elevance Health Public Policy Institute engaged and worked with us to assess the degree to which quality scores on pharmacy-related measures were affected by the state’s Medicaid managed care program design features.  The key issue assessed was whether quality scores were better in states where the prescription drug benefit was “carved-in” rather than “carved-out.”  We created 34 group comparisons between the two settings, and consistently found the Medicaid MCO quality scores to be superior in the carve-in setting. This finding occurred across years, across a wide set of behavioral health and physical health HEDIS measures, and in different regions of the country.

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