This report updates our 2024 assessment of which prescription drug model is best suited for Washington’s Apple Health (Medicaid) program. Simulating the carve-out on the most recent year where data are available (FFY2024), we estimate that changing to the carve-out approach would create additional total annual costs of $94.1 million for Washington’s Medicaid program, divided $59.0 million in additional state outlays and $35.1 million in additional federal outlays.
Our key recommendation is to preserve the existing carve-in structure – both for fiscal optimization and due to the wide array of programmatic advantages that occur under an integrated model of care and care coordination.