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Tag: Medicaid

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
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.

5-Slide Series

This edition looks at various state-level policy changes seeking to restrict inappropriate use of opioids, conducting a pre-versus-post comparison of prescription opioid usage related to the dates of these policy changes.

Publication

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 agency these rate increases will create — including the rate increase and the enhanced PDN capacity the higher payments can be expected to yield. The report also estimates the offsetting Medicaid savings that the increased PDN support can be expected to create via shortening and preventing hospitalizations.

5-Slide Series

This edition focuses on the trends in Medicaid prescription opioid and MAT use.  An example of our findings is that opioid prescriptions per Medicaid enrollee decreased 54% from 2013-2022.

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