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 looks at Medicaid eligibility trends, including stability in Medicaid coverage. We also find States with managed care tend to offer more stable Medicaid than FFS States.
- Keywords: Medicaid
This edition looks at Medicaid and Medicare combined costs. Nationwide, 2009 combined claims-based spending on Medicaid and Medicare represented approximately $800 billion in overall outlays, excluding most disproportionate share (DSH) and upper payment limit (UPL) supplemental payments. These claims-based expenditures were divided 42% for persons with Medicare coverage (but not Medicaid), 29% for persons with Medicaid coverage (and not Medicare), and 29% for Medicaid/Medicare dual eligibles. Together, Medicaid and Medicare represented 5.6% of Gross Domestic Product (GDP), $2,582 per resident, and $5,740 per working person above age 16, (excluding active duty military personnel).
- Keywords: Expenditures Medicaid Medicare
These slides are health policy focused, looking at areas where significant cost savings can/should occur, and identifying at a high level ways that these savings can best be redirected to improve overall health. Some of these concepts are relevant to current Sovaldi discussions, although the “value pricing” issue has much broader reach.
- Keywords: Expenditures Policy Prescription Drugs
This month’s edition provides data on the costs of Medicaid-covered adults and a conceptual framework for estimating the Medicaid expansion population’s emerging PMPM costs.
- Keywords: Expansion Expenditures Medicaid
The April 2014 edition of our five slide series focuses on historical Medicaid expenditure growth. The size of annual Medicaid cost increases do not seem to be driven by fluctuations in the economy or by which party holds the presidency. However, a correlation exists between the degree to which state governments are collectively under Democrat political control and relatively high percentage increases in Medicaid program costs. On a PMPM basis, data indicate an annual average cost increase from 2003-2010 very close to 5.0% for each of three major eligibility groups – children, adults (non-disabled, non-duals), and blind disabled (non-duals).
- Keywords: Expenditures Medicaid
This edition explores the dynamics of optimal coordinated care, in relation to governmental policies/actions and MCO operational activities. There are several combinations of ways that optimal care coordination programs are not yet being achieved. The construct described may be useful in identifying how a given program can be modified to better yield an optimal setting for facilitating access to needed care, ensuring that the services rendered are as cost-effective as possible, and helping covered populations maintain and improve their health status over the course of their daily lives. The years ahead create exciting opportunities to widen and strengthen partnerships between state and federal governments and the MCO industry in the Medicaid and Medicare arena.
This edition of the Series tabulates state average NCQA quality scores across the health plans that have been rated by NCQA. Separate averages have been calculated for Medicaid health plans, Medicare plans, and private plans.
This edition of the Series focuses on Medicaid MCO quality ratings, working with the data NCQA publishes each year. These slides calculate average quality scores in each of the 33 states with at least one NCQA-ranked plan. We also ranked the Medicaid MCOs by how their quality scores compares with the average of the other NCQA-ranked MCOs in their state.
This month’s 5-Slide Series examines CMS’ MSIS database to tabulate Medicaid costs across 18 service categories between 2007 and 2010. Capitation as a portion of total Medicaid expenditures increased 6.0 percentage points from 2007-2010. Additionally, capitation spending increased 57% from 2007 ($59 billion) to 2010 ($92 billion).
- Keywords: Expenditures Medicaid
This edition of the 5-Slide Series examines CY 2010 national Medicaid expenditures in the institutional setting. Nursing Homes, ICF/MR, and Mental Health Facilities collectively represented about one-fifth of national Medicaid expenditures. Dual eligibles accounted for 88% of nationwide Medicaid nursing home spending and 37% of all FY2010 Medicaid spending.
- Keywords: Expenditures Medicaid