5-Slide Series – Page 16 – The Menges Group

Medicaid Cost Per Prescription Differences Between States

We tabulated the cost per prescription for FFY 2014 using a 100% sample of Medicaid-paid prescriptions in each state. Medicaid's national average net (post-rebate) cost per prescription was $37 in 2014. Initial (pre-rebate) payments to pharmacies averaged $72 per prescription;…

Jul. 24, 2015 Download 5 slide

KEYWORDS:Expenditures, Medicaid, Prescription Drugs

Medicaid Pharmacy Carve-In and Carve-Out Dynamics

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…

Jun. 16, 2015 Download 5 slide

KEYWORDS:Medicaid, Pharmacy Carve Out, Prescription Drugs

Specialty Pharmacy’s Growing Role in Medicaid

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%…

May. 29, 2015 Download 5 slide

KEYWORDS:Expenditures, Medicaid, Prescription Drugs

Medicaid Data on Sovaldi, Harvoni and Kalydeco

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…

Apr. 30, 2015 Download 5 slide

KEYWORDS:Medicaid, Prescription Drugs

Medicaid Pharmacy Rebates

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…

Mar. 31, 2015 Download 5 slide

KEYWORDS:Expenditures, Medicaid, Prescription Drugs

ACO Evaluation Reporting To Date

This edition focuses on the reporting of ACO Evaluation results by CMS.

Feb. 17, 2015 Download 5 slide

KEYWORDS:Medicare

Honoring Accountability in Medicaid and 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.

Jan. 30, 2015 Download 5 slide

KEYWORDS:Medicaid, Medicare

Modernizing Medicare through Piloting Mandatory Enrollment in Care Coordination Programs

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…

Dec. 1, 2014 Download 5 slide

KEYWORDS:Enrollment, Medicaid, Medicare, Policy

Medicaid Demographic Mix

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…

Nov. 1, 2014 Download 5 slide

KEYWORDS:Enrollment, Medicaid

Financial Dynamics of Medicaid Expansion

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…

Oct. 31, 2014 Download 5 slide

KEYWORDS:Expansion, Expenditures, Medicaid

5 Slide Series