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Tag: Policy

Assessment of Pennsylvania’s Medicaid Preferred Drug List Policy Options

The Pennsylvania Coalition of Medical Assistance MCOs engaged The Menges Group to estimate the fiscal impacts of switching to a uniform PDL in Pennsylvania and to assess the programmatic advantages and disadvantages of this policy change. Our analyses indicate that…

May. 7, 2019 Download Full Report

KEYWORDS:Policy, Prescription Drugs

Piloting Medicare Mandatory Enrollment Into Coordinated Care

The May edition outlines a pilot program we encourage Medicare policymakers to adopt. It involves testing Medicaid’s key design features in the Medicare arena, which if successful could evolve into a fundamental transformation of Medicare as has occurred with Medicaid…

May. 1, 2019 Download 5 slide

KEYWORDS:Enrollment, Medicare, Policy

An Overview of a Pop Up Community Clinic in Redmond, WA

This edition describes a Pop-Up Clinic founded and led by one of our employees, Nehath Sheriff. This type of construct could be a low-cost, high-value option to consider for organizations seeking to “meet underserved subgroups where they are."

Apr. 1, 2019 Download 5 slide

KEYWORDS:Medicaid, Medicare, Policy

CY2018 Tax Estimates for the Average U.S. Family

This edition presents our tabulations on an “average family’s” federal, state and local taxes for CY2018 and how their tax contributions are spent.

Dec. 1, 2018 Download 5 slide

KEYWORDS:Expenditures, Medicaid, Medicare, Policy

Mid-Term Election Results and Medicaid Expansion

Our November Edition of the 5 Slide Series focuses on the 2018 election results and conveys some of the potential implications of these results regarding Medicaid expansion.

Nov. 1, 2018 Download 5 slide

KEYWORDS:Expansion, Medicaid, Policy

Assessment of Louisiana Medicaid’s Prescription Drug Management Performance and Preferred Drug List Policy Options

Legislation has been proposed in Louisiana to take the Medicaid preferred drug list (PDL) content responsibility away from the MCOs and shift it to a single state-determined PDL. The Menges Group assessed the impact of this policy option and estimated…

May. 16, 2018 Download Full Report

ADDITIONAL RESOURCES:

Executive Summary

KEYWORDS:Medicaid, Policy, Prescription Drugs

Assessment of Louisiana Medicaid’s Prescription Drug Carve-Out Option

Currently, Louisiana includes (carves in) the pharmacy benefit in its capitated contracts with Medicaid MCOs. During FFY2017, Louisiana had the nation’s most favorable Medicaid generic dispensing rate at 90.9% and the nation’s 8th best (lowest) cost per prescription. The Menges…

May. 15, 2018 Download Full Report

ADDITIONAL RESOURCES:

Executive Summary

KEYWORDS:Medicaid, Pharmacy Carve Out, Policy, Prescription Drugs

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.

Dec. 14, 2017 Download 5 slide

KEYWORDS:Medicaid, Medicare, Policy, Quality

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.

Jun. 4, 2017 Download 5 slide

KEYWORDS:Expenditures, Medicaid, Policy

Correctional Health: State Prison Inmate Health Costs and Strategies to Improve Re-entry

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.

Nov. 4, 2016 Download 5 slide

KEYWORDS:Expansion, Expenditures, Medicaid, Policy