Skip to Content
s - Skip to Content
0 - Access key details
1 - Back to top
2 - Header search

Data Analytics and Products

Overview

Thorough and objective data analysis is the foundation of effective decision-making. We assist organizations in making optimal use of their own data, and we also invest heavily in creating our own data sets to support our client work.

We work with our clients to quantify and track health disparities, identify accomplishments and improvement opportunities, evaluate prior initiatives, and better target care coordination activities.  We help put MCOs existing data to optimal use and help MCOs strengthen their data capture capabilities in areas such as social determinants of health.

Our in-house databases consolidate information on MCO quality and financial performance, Medicaid prescription drug usage and costs, and Medicaid enrollment.

Using this expertise, our Data Practice has assisted clients with:

  • Modeling the impact of new and proposed policy or program changes
  • Analyzing data to create pilot programs and measure their impacts
  • Estimating costs and savings from the implementation of new programs
  • Performing competitor health plan financial analyses
  • Benchmarking performance in areas such as prescription drug utilization and costs or quality performance
  • Identifying opportunities for cost savings from operational improvements
  • Highlighting achievements in operations
  • Identifying and analyzing health disparities to support our clients in developing new targeted initiatives

We work with our clients to design these data analysis models and ensure our clients are receiving maximum benefit from our work. Our unique approach uses multiple data sources, including our own proprietary datasets, which enables us to identify areas in which our clients can improve in operations and better market their achievements and operational successes.

Services

We are a national leader in analyzing Medicaid prescription drug costs, usage, and trends. The Menges Group has developed a database using multiple publicly available sources so that Medicaid prescription drug costs and usage can be analyzed at the national drug code (NDC) and therapeutic class level with various filters.

The Reports section of our website includes several examples of the work we have conducted in this arena. Examples of our work include:

  • Quantifying net Medicaid costs per prescription across states using different approaches to managing the Medicaid drug benefit.
  • Assessing the impacts of states switching from a Medicaid MCO “carve-in” to a “carve-out” model.
  • Assessing the net cost differences between states that provide MCOs with wide latitude in managing the mix of drugs, relative to requiring all MCOs to use the same preferred drug list (PDL).
  • Assessing trends in Medicaid prescription usage and costs during the COVID pandemic.
  • Assessing the challenges and opportunities with regard to medication adherence in the Medicaid arena
  • Quantifying the progression of price differentials between medications in the same drug class, such as the curative Hepatitis C medications.

Client Testimonials

“Your work has been phenomenal – exactly what we were hoping for when we envisioned this project.”
“I want to thank you again - not only has your team been a pleasure to work with but you have pulled off a Herculean feat.”
“I view the data analytics you have provided to be game changing.”

Publications

Assessment of NCQA Medicaid MCO Quality Ratings Across the Two Most Recent Measurement Years

This edition assesses changes and trends in NCQA Medicaid MCO quality ratings across measurement years 2023 and 2024.
Read more Volume 134

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. • Prescriptions per Medicaid enrollee have trended steadily downward since the onset...
Read more Volume 117

Georgia Medicaid MCO Profile Report, 2016-2017

Our June 2018 edition summarizes the recent financial performance and quality performance for Georgia’s health plans, as an example of the information we often provide our clients using these datasets.
Read more Volume 61

MCO Financial Performance During COVID

This edition looks at the collective financial performance of a large group of MCOs across the 2018-2021 timeframe. Our key findings are that the health plans performed quite well during the COVID-impacted years of 2020 and 2021 – better than they had performed during the pre-COVID years of 2018 and...
Read more Volume 107

Medicaid Expenditure Progression, 2013 – 2023

This edition quantifies the progression of Medicaid costs from 2013-2023 with a focus on the federal/state share of costs. Data are shown nationally, for each state and territory, and for various state groupings (regional, political, and by Medicaid Expansion adoption).
Read more Volume 132

Trends in the Use of Prescription Opioids and MAT in the Medicaid Program  ​

This edition focuses on the trends in Medicaid prescription opioid and MAT use.  An example of our findings is that opioid prescriptions per Medicaid enrollee decreased 54% from 2013-2022.
Read more Volume 120

Medicaid MCO Savings on Prescription Drug Costs – Therapeutic Class Level Comparisons

The September edition presents Medicaid data from our Pharmacy Practice, quantifying the differences in cost per prescription between the MCO and FFS settings in two selected high-volume therapeutic classes. In both drug classes (as occurs with Medicaid prescriptions overall), the MCO setting is achieving large percentage savings relative...
Read more Volume 64
prev
next
View Full Series
Back to top