5-Slide Series
The March edition tabulates the progression in Medicaid spending from 2012 – 2016, nationwide and with subtotals for states that did and didn’t adopt Medicaid expansion. One key statistic from this edition is that capitation rose from 25.7% of all Medicaid spending in 2012 to 48.7% in 2016 – the capitated model will likely represent the majority of Medicaid spending from 2017 forward.
5-Slide Series
The February edition tabulates overall health care expenditures from 2006-2016, and shows the progression of Medicaid, Medicare, and private health spending. A key observation from these tabulations is that health costs haven’t grown all that rapidly across the past decade – annual per capita cost increases have averaged 3.7% for the entire US population, 2.3% in Medicare, 3.2% in Medicaid, and 4.0% in the rest of the population.
5-Slide Series
The January edition tabulates the distribution of Medicaid pharmacy costs by unit price cohort. Explosive growth in the share of Medicaid prescriptions among drugs costing more than $1,000 per prescription (pre-rebate) continues to occur. These drugs now represent 40% of all Medicaid pre-rebate prescription drug expenditures.
5-Slide Series
The December Edition of the Series tabulates nationwide Medicaid prescription drug information from the beginning of 2015 through mid-2016. Some of the key findings are that Medicaid MCOs now pay for more than two-thirds of all Medicaid prescriptions, and that generics accounted for 81% of all Medicaid prescriptions but only 20% of Medicaid pre-rebate Rx expenditures during Q2 2016.
5-Slide Series
Volume #42 of our Series identifies the number of state prison inmates in each Medicaid expansion state, and describes opportunities to deliver community re-entry care coordination support.
5-Slide Series
Our October edition focuses on prescription drugs, tracking Medicaid’s nationwide unit price progression from 2013-2016 for each of the 25 NDCs generating the largest Medicaid expenditures. The average annual price increases across these 25 drugs was 10% (mean) and 8% (median), led by a more than doubling (133% overall increase) of the price of Epipen 2-Pak across the timeframe assessed.
5-Slide Series
This edition discusses – with some input from the Health Policy Cows – some do’s and don’ts for states in implementing Medicaid MCO procurements.
5-Slide Series
This month’s edition investigates prescription drug spending in all 50 states across three major state health care payers: Medicaid, state employee health plans, and in state prisons. By comparing these expenditures to total health care spending and overall spending in each state, one gets a better idea of the relative extent of state spending on prescription drugs.
5-Slide Series
The health policy cows are back for April’s report, which presents data and opinions regarding the need to pilot-test implementing managed care in the Medicare arena in a similar manner as typically occurs in Medicaid — mandatory enrollment of beneficiaries into a small number of competitively selected MCOs.
Publication
Over 90 percent of Louisiana’s Medicaid prescriptions are paid for by MCOs. The Louisiana Association of Health Plans engaged us to assess the impacts of a potential policy change to take the preferred drug list (PDL) content responsibility away from the Medicaid MCOs and shift it to a single state-administered and state-determined PDL. Our key finding is that this policy change would be costly to the State and its taxpayers – increasing overall annual Medicaid costs by $40 million and increasing annual State Fund expenditures by approximately $15 million. Our report provides evidence across dozens of states demonstrating that a focus on optimal management of Medicaid’s drug mix at the “front end” produces more favorable net costs than an approach that relies primarily on “back end” rebate maximization.
