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Tag: Expenditures

Use of Medicaid MCO Capitation by State – Projections for 2016

This September edition of the Five Slide Series is a set of projections of the degree to which each state’s Medicaid program will be “capitated” in 2016. Nationally and in several states, substantial movement to the capitated model has occurred…

Sep. 30, 2015 Download 5 slide

KEYWORDS:Expenditures, Medicaid

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

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 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

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

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…

Jul. 31, 2014 Download 5 slide

KEYWORDS:Expenditures, Medicaid, Medicare

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…

Jun. 30, 2014 Download 5 slide

KEYWORDS:Expenditures, Policy, Prescription Drugs

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.

May. 27, 2014 Download 5 slide

KEYWORDS:Expansion, Expenditures, Medicaid

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.…

Apr. 28, 2014 Download 5 slide

KEYWORDS:Expenditures, Medicaid

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…

Dec. 28, 2013 Download 5 slide

KEYWORDS:Expenditures, Medicaid