Getting Out of the Stairwell in Quality Measurement and Improvement
The December edition addresses some aspects of how quality data are reported and are used in performance-based payment structures.
Tag: Medicaid
Use of Capitation Contracting in Medicaid: State-by-State Overview as of 2016
The November 2017 edition looks state-by-state at the degree to which its 2016 Medicaid expenditures were capitated. Nationally, capitation payments represented 48.9% of FFY2016 Medicaid expenditures. This figure was 27% as of 2010. It is highly likely that we have…
Collective Financial Performance of Medicaid Health Plans: State-Level Analyses
The October 2017 edition summarizes an analysis of Medicaid MCO financial performance of Medicaid MCOs in each state, showing the degree to which the health plans are collectively experiencing gains or losses. During 2015 and 2016, about two-thirds of states…
Optimizing Medicaid Managed Care: Insights from Various Musicians
The September edition provides suggestions for making Medicaid managed care optimally effective.
Financial Performance of Medicaid-Focused Plans Across Past Several Years
The August edition tabulates information from the Medicaid MCO financial statements we collect and compile, showing the overall profitability among plans whose revenue is primarily (and often entirely) obtained through serving Medicaid populations.
Preserving Medicaid and Reducing the Program’s Spending
The June edition raises concerns with how Medicaid policymaking is currently being approached and debated. We identify specific areas where excess costs exist in the program and where considerable savings can be achieved without diminishing Medicaid’s current coverage levels.
MCOs’ Growing Role in the Medicaid Pharmacy Arena: Trends from 2013-2016
The May edition conveys the rapidly growing percentage of Medicaid prescriptions paid by managed care organizations (MCOs), and shows this progression in each state from 2013 through 2016
Medicaid MCO Financial Performance Overview 2015
The April edition provides Medicaid MCO financial performance statistics for 2015 – a compilation of 199 MCO financial statements. Collectively the industry earned a 2.4% operating margin on Medicaid business during 2015 with 71% of the MCOs achieving a positive…
Progression of Medicaid Spending from 2012-2016
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…
Progression of Health Spending in USA Across 2006-2016: Overall, Medicaid, Medicare and Private Sector
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…