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 June 2015 edition summarizes a full report we prepared in April, sponsored by America’s Health Insurance Plans. We believe this report, “Comparison of Medicaid Pharmacy Costs and Usage in Carve-In Versus Carve-Out States,” compellingly demonstrates the cost-effectiveness of using the pharmacy carve-in model.
- Keywords: Medicaid Pharmacy Carve Out Prescription Drugs
The May 2015 edition portrays the distribution of all Medicaid prescriptions by their unit cost corridor. These slides quantify the rapid growth in Medicaid prescriptions with a cost per prescription above $1,000. The high-cost medications in this corridor represented 1.3% of pre-rebate Medicaid pharmacy spending in 2005 but have increased to 28.4% of Medicaid pharmacy spending in 2013 and 32.6% of Medicaid pharmacy spending in 2014.
- Keywords: Expenditures Medicaid Prescription Drugs
The April 2015 edition presents recent nationwide and state-level data on Sovalidi usage. These slides also convey recent usage of a related Hepatitis C medication (Harvoni) as well as a specialty pharmacy drug, Kalydeco, in a completely different clinical area for comparison purposes.
- Keywords: Medicaid Prescription Drugs
This report summarizes Medicaid’s pharmacy costs during 2013 and 2014 and demonstrates the importance of viewing these expenditures on a net, post-rebate basis. Rebates accounted for 48.5% of the initial amount paid to pharmacies for Medicaid prescriptions during 2014, for example. The report also conveys the usage and cost information that is publicly available to date for Sovaldi.
- Keywords: Expenditures Medicaid Prescription Drugs
This edition focuses on the reporting of ACO Evaluation results by CMS.
- Keywords: Medicare
This edition of our Five Slide Series is focused on honoring accountability in Medicare and Medicaid — where it is being achieved and where it isn’t.
This edition of our Five Slide Series is Medicare-focused, policy-oriented, and qualitative and opinionated in nature. We report on the achievements the Medicaid program has made in the mandatory enrollment MCO model, and convey our thoughts on testing a similar approach in Medicare.
- Keywords: Enrollment Medicaid Medicare Policy
This edition of our Five Slide Series focuses quantitatively on Medicaid’s “footprint” in terms of the proportion of the country’s population served by the program by age, gender, and race. Our finding agree with the national consensus; Medicaid plays a disproportionately large role in covering our youngest residents, women, and many minority subgroups.
- Keywords: Enrollment Medicaid
This edition of the Five Slide Series estimates the amount each states’ residents are paying for the Medicaid expansion population’s coverage – whether or not their state is participating in the coverage program. In the aggregate, we estimate that an annual financial transfer of $17 billion is occurring from the residents of the non-expansion states to the residents of the expansion states. A state not yet participating in the expansion can move its residents from collectively being large-scale net losers to a large-scale net gainers by opting to participate.
- Keywords: Expansion Expenditures Medicaid
This edition assesses the 2014 NCQA Medicaid MCO quality scores. Analysis includes calculation of statewide average scores for all plans, top performing MCOs relative to their state’s average, comparisons by ownership (such as publicly traded versus non-publicly traded MCOs), and trends for scores from 2013-2014.