Survey of State Medicaid Drug Programs Finds Sharpened Focus on Costs and Value; Recent Federal Program Changes in Medicaid and Medicare Have Not Alleviated Financial Pressure
Contact: Lindsey Spindle, 202.207.1337,
Washington, DC – The National Association of State Medicaid Directors (NASMD) and Avalere Health have released a comprehensive survey on state Medicaid pharmacy policies. With responses from 47 Medicaid programs, the survey represents an expansive state-based view of current Medicaid pharmacy and practices to date.
Medicaid program coverage of pharmaceuticals has changed dramatically in light of the new Medicare Part D pharmaceutical benefit and the new flexibility granted to states in running their Medicaid programs under the Deficit Reduction Act of 2005 (DRA). The NASMD/Avalere survey provides a timely snapshot of state Medicaid programs’ opinions on how Part D and the DRA have impacted state management of pharmacy benefits and drug reimbursement practices. Among the major findings of the report:
“State pharmacy policies and practices bear a direct impact on the healthcare provided to Medicaid beneficiaries, overall state finances, and the healthcare industry,” said Jon Blum, a vice president at Avalere Health and contributing author to the report. “This report provides an indication how states are shaping their pharmacy policies to balance the tension between providing high quality benefits and managing costs.”
Approximately 55 million people – or 19% of the entire
The full report is entitled “State Perspectives on Emerging Medicaid Pharmacy Policies and Practices.” Avalere staff Andrea Kastin, Mike Cheek, and Jon Blum contributed to the development and analysis of the state survey.
Avalere Health is an advisory services company whose core purpose is to create innovative solutions to complex healthcare problems. Based in Washington DC, the firm delivers research, analysis, insight, and strategy for leaders in healthcare business and policy. Avalere's experts span 170 staff drawn from the federal government (e.g., CMS, OMB, CBO, and the Congress), Fortune 500 healthcare companies, top consultancies, and nonprofits. The firm offers deep substance in areas ranging from healthcare coverage and financing to the changing role of evidence in healthcare decision-making. Its focus on strategy is supported by a rigorous, in-house analytic research group that uses public and private data to generate quantitative insight. Through events, publications, and interactive programs, Avalere also translates real-time healthcare developments into actionable information.
Learn more at www.avalerehealth.net.
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