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 is most likely to occur in the upcoming year. This is also in alignment with CMS nationwide estimates of Medicaid prescription drug expenditure trends.
The August edition quantifies Medicaid DSH payments, showing the progression of DSH spending in each state from 2013-2017. The key takeaway is that Medicaid DSH has not dropped at all across the expansion states since 2013, even though this was intended to occur as one of the mechanisms to help offset the Federal costs of Medicaid expansion.
The November 2017 edition looks state-by-state at the degree to which its 2016 Medicaid expenditures were capitated. Nationally, capitation payments represented 48.9% of FFY2016 Medicaid expenditures. This figure was 27% as of 2010. It is highly likely that we have now crossed a threshold where the majority of Medicaid expenditures occur via capitation payments.
The July 2017 edition tabulates Medicare’s per capita costs in each state and U.S. territory, showing the level of cost variation that exists between jurisdictions. These figures are from 2015 and represent costs in the fee-for-service setting for Part A and Part B services.
The June edition raises concerns with how Medicaid policymaking is currently being approached and debated. We identify specific areas where excess costs exist in the program and where considerable savings can be achieved without diminishing Medicaid’s current coverage levels.
The March edition tabulates the progression in Medicaid spending from 2012 – 2016, nationwide and with subtotals for states that did and didn’t adopt Medicaid expansion. One key statistic from this edition is that capitation rose from 25.7% of all Medicaid spending in 2012 to 48.7% in 2016 – the capitated model will likely represent the majority of Medicaid spending from 2017 forward.
Progression of Health Spending in USA Across 2006-2016: Overall, Medicaid, Medicare and Private Sector
The February edition tabulates overall health care expenditures from 2006-2016, and shows the progression of Medicaid, Medicare, and private health spending. A key observation from these tabulations is that health costs haven’t grown all that rapidly across the past decade – annual per capita cost increases have averaged 3.7% for the entire US population, 2.3% in Medicare, 3.2% in Medicaid, and 4.0% in the rest of the population.
The January edition tabulates the distribution of Medicaid pharmacy costs by unit price cohort. Explosive growth in the share of Medicaid prescriptions among drugs costing more than $1,000 per prescription (pre-rebate) continues to occur. These drugs now represent 40% of all Medicaid pre-rebate prescription drug expenditures.
The December Edition of the Series tabulates nationwide Medicaid prescription drug information from the beginning of 2015 through mid-2016. Some of the key findings are that Medicaid MCOs now pay for more than two-thirds of all Medicaid prescriptions, and that generics accounted for 81% of all Medicaid prescriptions but only 20% of Medicaid pre-rebate Rx expenditures during Q2 2016.
Volume #42 of our Series identifies the number of state prison inmates in each Medicaid expansion state, and describes opportunities to deliver community re-entry care coordination support.