Publications – Page 2 – The Menges Group

Assessment of Kentucky’s Medicaid Managed Care Program Impacts

The purpose of this study is to assess the impacts of Kentucky’s Medicaid managed care program. The key components of this assessment include: • Cost impacts of the Medicaid managed care program across the past two decades • Performance on…

Nov. 1, 2021 Download Full Report

ADDITIONAL RESOURCES:

Executive Summary

KEYWORDS:Medicaid, Policy

Assessment of Medicaid Expansion Impacts

The purpose of this study is to compare the US states that have adopted the Affordable Care Act’s (ACA) Medicaid Expansion to the states that have not done so. The Medicaid Expansion makes people with incomes up to 138 percent…

Sep. 1, 2021 Download Full Report

KEYWORDS:Expansion, Medicaid

Assessment of New Jersey’s Medicaid Prescription Drug Management Performance and Policy Options

The New Jersey Association of Health Plans enlisted the Menges Group to evaluate New Jersey’s Medicaid prescription drug costs and assess the potential impacts of a pharmacy carve-out approach, whereby the prescription drug benefit would be removed from the MCOs’…

Feb. 16, 2021 Download Full Report

KEYWORDS:Pharmacy Carve Out, Policy, Prescription Drugs

Assessment of Common Core Formulary Impacts on Virginia Medicaid Managed Care Drug Spending

Virginia began implementing a Common Core Formulary within its Medicaid managed care program in 2017 for CCC Plus members and in 2018 for Medallion 4.0 members. The Virginia Association of Health Plans (VAHP) engaged The Menges Group to analyze the…

Jan. 14, 2020 Download Full Report

KEYWORDS:Expenditures, Medicaid, Prescription Drugs

Assessment of Virginia Medicaid Pharmacy Benefits Carve-Out Impacts

Some Virginia policymakers have indicated an interest in moving to a pharmacy “carve-out” within the Medicaid managed care program, whereby the state would instead manage the pharmacy benefit for MCO enrollees, including paying directly for drugs made available in the…

Jan. 14, 2020 Download Full Report

KEYWORDS:Medicaid, Pharmacy Carve Out, Policy

Value of Managed Care Organizations and Pharmacy Benefit Managers in Managing the Medicaid Prescription Drug Benefit

PCMA engaged The Menges Group to estimate the financial and programmatic value of managing the prescription drug benefit in the Medicaid managed care setting, comparing states that utilize MCOs – who contract with PBMs – for their prescription drug benefits…

Oct. 1, 2019 Download Full Report

KEYWORDS:Medicaid, Prescription Drugs

Assessment of Medi-Cal Pharmacy Benefits Policy Options

Policymakers are considering moving Medi-Cal to a pharmacy “carve-out” – that is, shifting the pharmacy benefit out of managed care to instead be administered by the state in fee-for-service (FFS). The carve-out proposal is motivated, in part, by the potential…

May. 15, 2019 Download Full Report

KEYWORDS:Pharmacy Carve Out, Policy

Assessment of Pennsylvania’s Medicaid Preferred Drug List Policy Options

The Pennsylvania Coalition of Medical Assistance MCOs engaged The Menges Group to estimate the fiscal impacts of switching to a uniform PDL in Pennsylvania and to assess the programmatic advantages and disadvantages of this policy change. Our analyses indicate that…

May. 7, 2019 Download Full Report

KEYWORDS:Policy, Prescription Drugs

Assessment of Report on Impacts of West Virginia Medicaid Prescription Drug Carve-Out

America’s Health Insurance Plans (AHIP) engaged The Menges Group to assess West Virginia’s Medicaid pharmacy carve-out impacts, analyzing the findings of another consulting firm’s report. Our analyses suggest that West Virginia’s carve-out has created increased Medicaid expenditures rather than savings.…

Apr. 1, 2019 Download Full Report

KEYWORDS:Medicaid, Pharmacy Carve Out, Prescription Drugs

New York Medicaid Prescription Drug Expenditure Trends

The Menges Group was asked to update an analysis of New York’s Medicaid prescription drug expenditure growth over the past several state fiscal years (SFY). Based on our analysis of year-over-year trends since SFY2014, we anticipate that single-digit annual growth…

Nov. 5, 2018 Download Full Report

KEYWORDS:Expenditures, Medicaid, Prescription Drugs