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Tag: Medicaid

5-Slide Series

This edition provides information on Medicaid’s fiscal redistributional dynamics. For example, during FFY2023 Trump-won states collectively gained $16.8 billion between the amounts residents of these states contributed to Medicaid (via their Federal and state taxes) and the level of Medicaid spending that took place in their states.

5-Slide Series

The second edition of our Medicaid Unwinding and Redeterminations 5 Slide Mini-Series explores Medicaid coverage renewal outcomes across states during the unwinding period (March 2023- July 2024).

5-Slide Series

This first edition of our Medicaid Unwinding and Redeterminations 5 Slide Mini-Series provides an overview of Medicaid eligibility and enrollment trends during and after the COVID-19 public health emergency (PHE).

5-Slide Series

This edition delves into NCQA’s Medicaid health plan overall quality ratings for performance years 2022 and 2023. A key component of our analyses involved creating enrollment weighted average scores for the Medicaid health plans operating in multiple states, and similar average scores across the health plans serving Medicaid in each state.

Publication

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 managed by a separate company using a fee-for service (FFS) payment mechanism. Our overall recommendation is that Washington should preserve the carve-in pharmacy model for the Medicaid program

5-Slide Series

This edition focuses on Medicaid MCO procurements, an area where our company conducts vast project work. We describe a few actions states can take to get the most value out of their procurements. We also offer some thoughts regarding how states can better overcome a protest process that seems to have become increasingly problematic.

5-Slide Series

This 5 Slide Series edition provides our tabulations and analysis of NCQA’s Quality Ratings for Medicaid MCOs juxtaposed with the specialized accreditations NCQA has awarded to these health plans.

5-Slide Series

This 5 Slide Series edition provides our tabulations and analysis of the NCQA Quality Ratings for Medicaid MCOs (Rating Year 2022-2023).

5-Slide Series

This edition provides excerpts of opioid-related questions that have appeared in Medicaid MCO procurements. These slides demonstrate some of the ways in which states are using their request for proposal (RFP) process to promote innovation and elevate the MCOs’ mechanisms to effectively serve enrollees who have opioid use disorder.

Publication

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 PDN rate increase is projected to yield.

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