Our 5 Slide Series allows us to regularly present objective analyses and trends on issues we believe are of interest and share our findings through data tabulations and visualizations.
The March 2018 edition of our 5 Slide Series tracks the national Medicaid market share and pre-rebate cost per prescription progression of curative Hepatitis C drugs from CY2014 through CY2017. The introduction of newer, lower cost-per-unit drugs has resulted in a significant shift in market share within this category of drugs. Additionally, we have quantified the considerable market share differences between MCO-paid and FFS-paid Medicaid prescriptions.
- Keywords: Medicaid Prescription Drugs
This edition focuses on the 46 health care companies on the current Fortune 500 list, conveying their ranking in CY2016 revenues and profits, and their percentage profit margins. During CY2000, no health care companies were in Fortune’s top 25 – now there are seven.
- Keywords: Fortune 500
This edition conveys the progression of the number of Medicare Special Needs Plans (SNPs) and enrollment from December 2010 through January 2018. As of January 2018, overall SNP enrollment reached an all-time high of more than 2.5 million persons, the vast majority of whom are dual eligibles covered by Medicaid and Medicare.
- Keywords: Enrollment Medicare Special Needs Plan
The December edition addresses some aspects of how quality data are reported and are used in performance-based payment structures.
The November 2017 edition looks state-by-state at the degree to which its 2016 Medicaid expenditures were capitated. Nationally, capitation payments represented 48.9% of FFY2016 Medicaid expenditures. This figure was 27% as of 2010. It is highly likely that we have now crossed a threshold where the majority of Medicaid expenditures occur via capitation payments.
- Keywords: Expenditures Medicaid
The October 2017 edition summarizes an analysis of Medicaid MCO financial performance of Medicaid MCOs in each state, showing the degree to which the health plans are collectively experiencing gains or losses. During 2015 and 2016, about two-thirds of states with MCO capitation programs landed in what we would consider an optimal place – with the health plans collectively earning a positive margin on their Medicaid business but with that margin not exceeding 5%.
- Keywords: Financial Performance Medicaid
The September edition provides suggestions for making Medicaid managed care optimally effective.
- Keywords: Medicaid
The August edition tabulates information from the Medicaid MCO financial statements we collect and compile, showing the overall profitability among plans whose revenue is primarily (and often entirely) obtained through serving Medicaid populations.
- Keywords: Financial Performance Medicaid
The July 2017 edition tabulates Medicare’s per capita costs in each state and U.S. territory, showing the level of cost variation that exists between jurisdictions. These figures are from 2015 and represent costs in the fee-for-service setting for Part A and Part B services.
- Keywords: Expenditures Medicare
The June edition raises concerns with how Medicaid policymaking is currently being approached and debated. We identify specific areas where excess costs exist in the program and where considerable savings can be achieved without diminishing Medicaid’s current coverage levels.
- Keywords: Expenditures Medicaid Policy