The Value Of Medicaid Managed Care

posted by AHIP

on February 24, 2020

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.

" "