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Tag: Medicaid

Medicaid Data on Sovaldi, Harvoni and Kalydeco

The April 2015 edition presents recent nationwide and state-level data on Sovalidi usage. These slides also convey recent usage of a related Hepatitis C medication (Harvoni) as well as a specialty pharmacy drug, Kalydeco, in a completely different clinical area…

Apr. 30, 2015 Download 5 slide

KEYWORDS:Medicaid, Prescription Drugs

Comparison of Medicaid Pharmacy Costs and Usage in Carve-In Versus Carve-Out States

This study examined 35 states and DC that used the Managed Care Organization (MCO) model in their Medicaid program and either included (carved-in) or excluded (carved-out) pharmacy benefits from coverage. The report found that carve-in states outperform carve-out states by…

Apr. 16, 2015 Download Full Report

KEYWORDS:Medicaid, Pharmacy Carve Out, Policy, 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

Honoring Accountability in Medicaid and Medicare

This edition of our Five Slide Series is focused on honoring accountability in Medicare and Medicaid -- where it is being achieved and where it isn't.

Jan. 30, 2015 Download 5 slide

KEYWORDS:Medicaid, Medicare

Modernizing Medicare through Piloting Mandatory Enrollment in Care Coordination Programs

This edition of our Five Slide Series is Medicare-focused, policy-oriented, and qualitative and opinionated in nature. We report on the achievements the Medicaid program has made in the mandatory enrollment MCO model, and convey our thoughts on testing a similar…

Dec. 1, 2014 Download 5 slide

KEYWORDS:Enrollment, Medicaid, Medicare, Policy

Medicaid Demographic Mix

This edition of our Five Slide Series focuses quantitatively on Medicaid’s “footprint” in terms of the proportion of the country’s population served by the program by age, gender, and race. Our finding agree with the national consensus; Medicaid plays a…

Nov. 1, 2014 Download 5 slide

KEYWORDS:Enrollment, Medicaid

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

Assessment of 2014 Medicaid MCO Quality Rankings

This edition assesses the 2014 NCQA Medicaid MCO quality scores. Analysis includes calculation of statewide average scores for all plans, top performing MCOs relative to their state's average, comparisons by ownership (such as publicly traded versus non-publicly traded MCOs), and…

Sep. 30, 2014 Download 5 slide

KEYWORDS:Medicaid, Quality

Medicaid Eligibility Statistical Analysis and Comparisons

This edition looks at Medicaid eligibility trends, including stability in Medicaid coverage. We also find States with managed care tend to offer more stable Medicaid than FFS States.

Aug. 4, 2014 Download 5 slide

KEYWORDS: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