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Tag: Medicaid

Trends in Medicaid’s Average Costs Per Prescription

This edition presents our tabulations of Medicaid pharmacy cost and price trends. Some of our key findings: Nationwide Medicaid pre-rebate costs per prescription increased at an annual average rate of 5.6% from 2012-2021, led by an 11.9% annual rate of…

Jun. 21, 2022 Download 5 slide

KEYWORDS:Expenditures, Medicaid, Prescription Drugs

Medicaid Pharmacy Usage During COVID

This edition quantifies the decrease in Medicaid prescription volume that has occurred during COVID, comparing usage during calendar years 2019, 2020, and 2021. The large decrease that has occurred – 16.4% from 2019 to 2021 on a per covered person…

May. 30, 2022 Download 5 slide

KEYWORDS:COVID-19, Medicaid, Prescription Drugs

Medicaid Prescription Drug Benefit Management: Performance Comparison Across Different State Policy Approaches

We were enlisted by the Anthem Public Policy Institute to assess the cost-effectiveness of different states’ approaches to managing Medicaid prescription drug benefit. States were grouped into five cohorts depending on the degree to which their Medicaid prescriptions are paid…

Apr. 1, 2022 Download 5 slide

KEYWORDS:Expenditures, Medicaid, Prescription Drugs

Medicaid Prescription Drug Benefit Management: Performance Comparison Across Different State Policy Approaches

States that employ Medicaid managed care organizations (MCOs) to pay for prescription drugs outperform states that rely on the fee-for-service (FFS) setting to control drug costs. Despite larger rebates in FFS, MCOs’ effective strategies to encourage...

Mar. 1, 2022 Download Full Report

ADDITIONAL RESOURCES:

Executive Summary

KEYWORDS:Expenditures, Medicaid, Prescription Drugs

Assessment of Kentucky’s Medicaid Managed Care Program Impacts

The purpose of this study is to assess the impacts of Kentucky’s Medicaid managed care program. The key components of this assessment include: • Cost impacts of the Medicaid managed care program across the past two decades • Performance on…

Nov. 1, 2021 Download Full Report

ADDITIONAL RESOURCES:

Executive Summary

KEYWORDS:Medicaid, Policy

Medicaid Spending by State During Fiscal Year 2020

This edition of our 5 Slide Series examines state Medicaid spending during Federal Fiscal Year 2020. Using expenditure reports from CMS, we calculated the share of each state’s Medicaid spending that occurred via capitation. Capitation represented the majority (52.6%) of…

Oct. 18, 2021 Download 5 slide

KEYWORDS:Expenditures, Medicaid

Assessment of Medicaid Expansion Impacts

The purpose of this study is to compare the US states that have adopted the Affordable Care Act’s (ACA) Medicaid Expansion to the states that have not done so. The Medicaid Expansion makes people with incomes up to 138 percent…

Sep. 1, 2021 Download Full Report

KEYWORDS:Expansion, Medicaid

Medicaid Expansion Impacts

This edition of our 5 Slide Series coincides with today’s release of a new report, “Assessment of Medicaid Expansion’s Impacts.” The 5 Slide Series creates an opportunity for our staff team to contribute to the Medicaid industry outside the boundaries of…

Aug. 23, 2021 Download 5 slide

KEYWORDS:Expansion, Medicaid

Assessment of Common Core Formulary Impacts on Virginia Medicaid Managed Care Drug Spending

Virginia began implementing a Common Core Formulary within its Medicaid managed care program in 2017 for CCC Plus members and in 2018 for Medallion 4.0 members. The Virginia Association of Health Plans (VAHP) engaged The Menges Group to analyze the…

Jan. 14, 2020 Download Full Report

KEYWORDS:Expenditures, Medicaid, Prescription Drugs

Assessment of Virginia Medicaid Pharmacy Benefits Carve-Out Impacts

Some Virginia policymakers have indicated an interest in moving to a pharmacy “carve-out” within the Medicaid managed care program, whereby the state would instead manage the pharmacy benefit for MCO enrollees, including paying directly for drugs made available in the…

Jan. 14, 2020 Download Full Report

KEYWORDS:Medicaid, Pharmacy Carve Out, Policy