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Tag: Policy

5-Slide Series

This edition quantifies the large gender gaps that exist at the leadership level within U.S. companies. For example, females currently comprise only 10.6% of Fortune 500 Company CEOs. Females are getting closer to parity among attorneys (38%) and physicians (37%), and the trends are all in the direction of parity. However, the gender mix is changing slowly and the disparities remain disturbingly wide.

5-Slide Series

This edition of our 5 Slide Series quantifies the very low percentage of women serving in national political leadership positions.

Publication

The Elevance Health Public Policy Institute engaged and worked with us to assess the degree to which quality scores on pharmacy-related measures were affected by the state’s Medicaid managed care program design features. The key issue assessed was whether quality scores were better in states where the prescription drug benefit was “carved-in” rather than “carved-out.” We created 34 group comparisons between the two settings, and consistently found the Medicaid MCO quality scores to be superior in the carve-in setting. This finding occurred across years, across a wide set of behavioral health and physical health HEDIS measures, and in different regions of the country.

Publication

Building upon our 2014 report titled Prescription Drug Adherence in Medicaid Managed Care, this report provides updated analyses performed on medication adherence, assesses the impacts of Medicaid expansion and the COVID-19 pandemic on medication adherence, and offers recommendations for further improvement to Medicaid medication access and adherence.

5-Slide Series

This edition conveys some of our perspectives related to the current reinstatement of Medicaid redeterminations. This is an important time period to capture (and share) detailed information on how Medicaid enrollees can best be successfully reached, as well as the dynamics of continuous enrollment, coverage retention and loss. We delineate several specific data points that will be valuable to collect.

5-Slide Series

This edition focuses on the share of the overall population that receives Medicaid, and how this percentage has trended throughout the past decade nationally and state by state. Between Medicaid expansion, COVID dynamics, and some shifts in the economy’s performance, the past ten years have created several interesting Medicaid enrollment trends and large-scale shifts. Altogether, Medicaid enrollment jumped up 57% from 2013-2022, an increase of 36.2 million persons. Kentucky has experienced the largest rate of growth, ranking 42nd during 2013 in terms of the proportion of its overall population receiving Medicaid coverage and moving all the way to 8th as of 2022.

5-Slide Series

This edition looks at state implementation of Medicaid postpartum coverage extension and Medicaid expansion by state. We also present rates of postpartum care utilization in the Medicaid population before and after implementation of postpartum coverage extension. As of March 2023, 45 states and D.C. have implemented Medicaid expansion and/or Medicaid postpartum coverage extension.

Publication

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 key quality measures
• Opioid and medication-assisted treatment (MAT) prescription drug usage trends
• Kentucky’s recent experience with COVID-19 vaccinations
• Minimum contract requirements for managed care organizations (MCOs) to participate in Kentucky’s Medicaid program
• Competitive procurement dynamics

Publication

The New Jersey Association of Health Plans enlisted the Menges Group to evaluate New Jersey’s Medicaid prescription drug costs and assess the potential impacts of a pharmacy carve-out approach, whereby the prescription drug benefit would be removed from the MCOs’ responsibility and paid for in the fee-for-service (FFS) setting. We also assess the impacts of two potential policy changes, including maintaining MCO responsibility for the prescription drug benefit but requiring the use of the same preferred drug list (PDL) and MCOs’ mandatory use of a single Pharmacy Benefits Manager (PBM) subcontractor.

We estimate that carving pharmacy benefits out of the MCO benefit package will cost the State of New Jersey $51 million in the first year, with cumulative state costs across the first five years of the carve-out totaling $454 million. Additionally, we find that due to a weakened ability to manage drug mix at the “front end,” moving to a uniform DHS-driven PDL will cost the State of New Jersey $3 million in the first year, with cumulative state costs across the first five years totaling $26 million. Finally, our analyses show that a policy approach of requiring all MCOs to use the same PBM is also unlikely to yield savings.

5-Slide Series

This edition about the pandemic zooms in on California, Louisiana, Massachusetts, and New Jersey, conveying county-level tabulations regarding the per capita rate of confirmed COVID-19 cases as of yesterday. We also show the number and proportion of Medicare beneficiaries in each county. 

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