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Tag: Expenditures

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%…

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…

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…

Combined Spending on Medicaid and Medicare by State

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…

Eliminating Excess Costs and Redeploying Savings

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…

Medicaid Expansion: Initial Findings on Costs

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.

Medicaid Cost Trends

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.…

Medicaid Costs by Service 2007-2010

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…

Nursing Home and Institutional Care – Medicaid Costs

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…

Persons with Disabilities – Medicaid Per Capita Costs

This edition of our 5-slide series examines Medicaid per capita costs for individuals with disabilities and provides recommendations for how to manage this population. 22.1% of nationwide spending for disabled non-duals was paid via capitation during 2010 (versus 50.2% for…
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