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Tag: Expenditures

Medicaid Expenditure Progression, 2013 – 2023

This edition quantifies the progression of Medicaid costs from 2013-2023 with a focus on the federal/state share of costs. Data are shown nationally, for each state and territory, and for various state groupings (regional, political, and by Medicaid Expansion adoption).

Jul. 9, 2025 Download 5 slide

KEYWORDS:Expansion, Expenditures, Medicaid

Assessment of Washington State’s Medicaid Prescription Drug Management Performance and Policy Options

This report explores which prescription drug model is best suited for Washington’s Apple Health (Medicaid) program: the current carve-in prescription drug model, under which managed care organizations (MCOs) pay for members’ prescriptions, or a carve out model, where prescriptions are…

Oct. 21, 2024 Download Full Report

KEYWORDS:Expenditures, Medicaid, Pharmacy Carve Out, Prescription Drugs

Costs and Benefits of Enhancing Private Duty/Shift Nursing Payment Rates in Pennsylvania’s Medicaid Program

This report was enlisted by the Pennsylvania Homecare Association to evaluate the need for enhancing Pennsylvania’s Medicaid Private Duty Nursing (PDN) payment rates. Through a mixture of quantitative analyses and real-life patient examples, this report highlights the anticipated benefits this…

Apr. 25, 2024 Download Full Report

KEYWORDS:Expenditures, Medicaid, Policy

Costs and Benefits of Enhancing Private Duty Nursing Payment Rates in Colorado’s Medicaid Program

This report was commissioned by the Home Care and Hospice Association of Colorado. The report derives the Medicaid payment rate increase needed to attract adequate private duty nursing (PDN) service capacity in Colorado. We’ve estimated the cost to the Medicaid…

Mar. 12, 2024 Download Full Report

KEYWORDS:Expenditures, Medicaid, Policy

Assessment of Medicaid Expenditure and Capitation Trends From 2011-2021

This edition looks at state-level and national Medicaid spending trends, first overall and then by the share of Medicaid spending that is paid via capitation.

Dec. 20, 2022 Download 5 slide

KEYWORDS:Expenditures, Medicaid

Trends in Medicaid Use of Capitation

This edition looks at the progression of capitation contracting in the Medicaid program at the national and state levels. As s a percentage of total Medicaid spending, capitation contracting has grown 31.1% in FFY2013 to 55.9% in FFY2021. National Medicaid…

Sep. 1, 2022 Download 5 slide

KEYWORDS:Expenditures, Medicaid

Trends in Medicaid’s Average Costs Per Prescription

This edition presents our tabulations of Medicaid pharmacy cost and price trends. Some of our key findings: Nationwide Medicaid pre-rebate costs per prescription increased at an annual average rate of 5.6% from 2012-2021, led by an 11.9% annual rate of…

Jun. 21, 2022 Download 5 slide

KEYWORDS:Expenditures, Medicaid, Prescription Drugs

Medicaid Prescription Drug Benefit Management: Performance Comparison Across Different State Policy Approaches

We were enlisted by the Anthem Public Policy Institute to assess the cost-effectiveness of different states’ approaches to managing Medicaid prescription drug benefit. States were grouped into five cohorts depending on the degree to which their Medicaid prescriptions are paid…

Apr. 1, 2022 Download 5 slide

KEYWORDS:Expenditures, Medicaid, Prescription Drugs

Medicaid Prescription Drug Benefit Management: Performance Comparison Across Different State Policy Approaches

States that employ Medicaid managed care organizations (MCOs) to pay for prescription drugs outperform states that rely on the fee-for-service (FFS) setting to control drug costs. Despite larger rebates in FFS, MCOs’ effective strategies to encourage...

Mar. 1, 2022 Download Full Report

ADDITIONAL RESOURCES:

Executive Summary

KEYWORDS:Expenditures, Medicaid, Prescription Drugs

Medicaid Spending by State During Fiscal Year 2020

This edition of our 5 Slide Series examines state Medicaid spending during Federal Fiscal Year 2020. Using expenditure reports from CMS, we calculated the share of each state’s Medicaid spending that occurred via capitation. Capitation represented the majority (52.6%) of…

Oct. 18, 2021 Download 5 slide

KEYWORDS:Expenditures, Medicaid