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Tag: Pharmacy Carve Out

Assessment of the Pharmacy Carve-In Model for Virginia’s Medicaid Program

This report explores the fiscal and programmatic impacts that a switch to a prescription drug carve-out model, where the pharmacy benefit would be managed under a single-payer system within Medicaid using the fee-for-service payment methodology, would have on Virginia’s Medicaid…

Assessment of Washington State’s Medicaid Prescription Drug Management Performance and Policy Options

This report explores which prescription drug model is best suited for Washington’s Apple Health (Medicaid) program: the current carve-in prescription drug model, under which managed care organizations (MCOs) pay for members’ prescriptions, or a carve out model, where prescriptions are…

Medicaid Prescription Drug Trends

This edition summarizes our tabulations of several key Medicaid prescription drug cost and usage trends across the 2018-2022 timeframe. Our findings include: • Pre-rebate costs per Medicaid prescription grew sharply, at an average annual rate of 9.7% from 2018-2022. •…
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