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.
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
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.
- Keywords: Enrollment Medicaid Medicare Policy
This month’s edition aggregates the financial performance of the nine largest US health insurers and presents these companies’ revenues, expenses, taxes, and net income from 2012 to 2015. This comparison reveals substantial growth in the health insurance industry with consistent yearly profit margins, even after paying sizeable amounts of income taxes.
- Keywords: Financial Performance
The February report pieces together different data on prescription volume by state – mostly through our staff’s tabulations – showing the distribution of each state’s total 2015 prescriptions between those paid by Medicaid, Medicare Part D, and all other payer sources combined. There was considerable variation in this percentage distribution in each state.
- Keywords: Medicaid Medicare Prescription Drugs
This edition provides data on Medicaid prescription drug usage and costs and trends from 2013 to 2015. Each data table shows national totals and subtotals for three groups of states: non-expansion states, initial Medicaid expansion states (those implementing Medicaid expansion in January 2014), and subsequent expansion states. The tables show all Medicaid-paid pharmacy volume, including prescriptions paid by Medicaid MCOs and those paid in the Medicaid fee-for-service setting. Tables differentiate pre-rebate and post-rebate spending.
- Keywords: Expansion Expenditures Medicaid Prescription Drugs
This edition encourages states to ascertain (and fix) situations where providers are securing prices far above Medicaid fee-for-service by way of a leveraged negotiation outcome with the Medicaid health plans in their market area. This dynamic, in our view, is often negating the taxpayer savings that the Medicaid health plans’ excellent care coordination work would otherwise be achieving.
- Keywords: Medicaid
For the November edition of the Five Slide Series we tabluated the costs and usage of three prevalent Hepatitis C medications – Sovaldi, Harvoni, and Viekira Pak. These drugs have all been introduced within the last 2 years and have exploded in popularity over that span, despite the high prices they command. In this slide deck we look at these drugs on a state-by-state basis, as well as on the national level.
- Keywords: Expenditures Medicaid Prescription Drugs
This October edition of the Five Slide Series quantifies the monthly influx of the Medicaid expansion population through March of 2015. Expansion enrollment increased throughout the 15 month period in 14 of the 15 states reviewed.
- Keywords: Enrollment Expansion Medicaid
This September edition of the Five Slide Series is a set of projections of the degree to which each state’s Medicaid program will be “capitated” in 2016. Nationally and in several states, substantial movement to the capitated model has occurred in recent years and this constitutes “true health reform” – fundamentally changing how Medicaid services are being accessed, delivered, and paid for.
- Keywords: Expenditures Medicaid