Making Prescription Drugs More Affordable for States and Taxpayers
Highlights
Medicaid MCOs cover the bulk of Medicaid prescriptions nationwide. More than 70% of all Medicaid prescriptions nationwide were covered by Medicaid managed care plans in 2018, compared to only 28% in 2011.
Medicaid MCOs’ net costs per prescription were approximately 27% below net costs per prescription paid in Medicaid fee-for-service1 (FFS) programs. This differential yielded $6.5 billion in net savings for states and taxpayers during FFY2 2018.
MCOs consistently control costs more effectively than FFS programs. Over the five-year period 2013 to 2018, net costs per prescription increased 13% more in FFS programs than in MCOs.