Menges Group 5 Slides Series for August, September, & October 2018

The Menges Group puts out these great analyses and insights each month. And is kind enough to let us repost them for the MM audience. Check out to learn more about the work they do. 

The August edition quantifies Medicaid DSH payments, showing the progression of DSH spending in each state from 2013-2017.  The key takeaway is that Medicaid DSH has not dropped at all across the expansion states since 2013, even though this was intended to occur as one of the mechanisms to help offset the Federal costs of Medicaid expansion.

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 to FFS.  However, the path taken to achieve these savings is quite different between the two drug classes shown.

October’s edition conveys some of our tabulations working with the recently published NCQA Medicaid health plan quality ratings for Rating Year 2018-2019.  AmeriHealth Caritas and UnitedHealthcare are the two top-rated national chain organizations in terms of their average NCQA rating across the states they serve.  Among the 13 Medicaid MCOs with a rating of 4.5 or above, the plans achieving this excellent quality score on the largest Medicaid membership base are Health Partners Plans in Pennsylvania, Neighborhood Health Plan of Rhode Island, and Priority Health in Michigan.

Medicaid DSH Spending Trends — August 2018

Medicaid MCO Rx Cost Savings at Therapeutic Class Level — September 2018

Medicaid MCO Quality Overview, NCQA Ratings for 2018-2019 — October 2018