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 April edition provides Medicaid MCO financial performance statistics for 2015 – a compilation of 199 MCO financial statements. Collectively the industry earned a 2.4% operating margin on Medicaid business during 2015 with 71% of the MCOs achieving a positive margin and 29% experiencing a loss. An interesting finding was that the health plans’ percent operating margins were not correlated with plan size.
- Keywords: Financial Performance Medicaid
The March edition tabulates the progression in Medicaid spending from 2012 – 2016, nationwide and with subtotals for states that did and didn’t adopt Medicaid expansion. One key statistic from this edition is that capitation rose from 25.7% of all Medicaid spending in 2012 to 48.7% in 2016 – the capitated model will likely represent the majority of Medicaid spending from 2017 forward.
- Keywords: Expenditures Medicaid
The February edition tabulates overall health care expenditures from 2006-2016, and shows the progression of Medicaid, Medicare, and private health spending. A key observation from these tabulations is that health costs haven’t grown all that rapidly across the past decade – annual per capita cost increases have averaged 3.7% for the entire US population, 2.3% in Medicare, 3.2% in Medicaid, and 4.0% in the rest of the population.
- Keywords: Expenditures Medicaid Medicare
The January edition tabulates the distribution of Medicaid pharmacy costs by unit price cohort. Explosive growth in the share of Medicaid prescriptions among drugs costing more than $1,000 per prescription (pre-rebate) continues to occur. These drugs now represent 40% of all Medicaid pre-rebate prescription drug expenditures.
- Keywords: Expenditures Medicaid Prescription Drugs
The December Edition of the Series tabulates nationwide Medicaid prescription drug information from the beginning of 2015 through mid-2016. Some of the key findings are that Medicaid MCOs now pay for more than two-thirds of all Medicaid prescriptions, and that generics accounted for 81% of all Medicaid prescriptions but only 20% of Medicaid pre-rebate Rx expenditures during Q2 2016.
- Keywords: Expenditures Medicaid Prescription Drugs
Volume #42 of our Series identifies the number of state prison inmates in each Medicaid expansion state, and describes opportunities to deliver community re-entry care coordination support.
- Keywords: Expansion Expenditures Medicaid Policy
Our October edition focuses on prescription drugs, tracking Medicaid’s nationwide unit price progression from 2013-2016 for each of the 25 NDCs generating the largest Medicaid expenditures. The average annual price increases across these 25 drugs was 10% (mean) and 8% (median), led by a more than doubling (133% overall increase) of the price of Epipen 2-Pak across the timeframe assessed.
- Keywords: Medicaid Prescription Drugs
As of September 2016, 32% of Medicare beneficiaries were enrolled in a Medicare Advantage health plan. This edition produces MCO penetration statistics for each state and provides some county level tabulations. For example, in 137 counties Medicare health plans currently serve more than half of the Medicare beneficiaries residing in that county. The highest statewide penetration is in Minnesota (55.5%).
- Keywords: Enrollment Medicare
This edition discusses – with some input from the Health Policy Cows – some do’s and don’ts for states in implementing Medicaid MCO procurements.
- Keywords: Medicaid Policy Procurement
This month’s edition investigates prescription drug spending in all 50 states across three major state health care payers: Medicaid, state employee health plans, and in state prisons. By comparing these expenditures to total health care spending and overall spending in each state, one gets a better idea of the relative extent of state spending on prescription drugs.
- Keywords: Expenditures Medicaid Policy Prescription Drugs