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What Drives Spending and Utilization on Medicaid Drug Benefits in States?

With the approval of new specialty drugs, such as the Hepatitis C treatments Sovaldi and Harvoni, states are mindful that the cost the Medicaid prescription drug benefit could increase. To achieve savings, and improve management and health outcomes, it is important to understand which drugs are most frequently prescribed and which drive spending. Using state drug utilization data provided through the Medicaid Drug Rebate Program, as well as an industry drug database, this issue brief examines trends in prescriptions and spending before rebates, and places findings in the context of policy discussion.

States Expanding Medicaid Under the Affordable Care Act Expect 18% Enrollment Growth in Fiscal Year 2015, With Federal Funds Picking Up Most of the Cost

States expect the number of people enrolled in Medicaid will increase an average of 13.2 percent across the country in state fiscal year 2015 (which runs through June in most states), showing the early effects of the first full year of Affordable Care Act implementation, according to the 14th annual 50-State Medicaid budget survey by the Kaiser Family Foundation’s Commission on Medicaid and the Uninsured (KCMU).

Medicaid in an Era of Health & Delivery System Reform: Results from a 50-State Medicaid Budget Survey for State Fiscal Years 2014 and 2015

This report provides an in depth examination of the changes taking place in state Medicaid programs across the country. The findings in this report are drawn from the 14th annual budget survey of Medicaid officials in all 50 states and the District of Columbia conducted by the Kaiser Commission on Medicaid and the Uninsured and Health Management Associates (HMA), with the support of the National Association of Medicaid Directors. This report highlights policy changes implemented in state Medicaid programs in FY 2014 and those planned for implementation in FY 2015 based on information provided by the nation’s state Medicaid Directors. Key areas covered include changes in eligibility and enrollment, delivery systems, provider payments and taxes, benefits, pharmacy programs, program integrity and program administration.

Medicare Part D: A First Look at Plan Offerings in 2015

This issue brief provides an overview of the Medicare Part D stand-alone prescription drug plan options available in 2015 and key changes from prior years. The analysis examines Part D plan availability, premiums, benefit design features, and low income subsidy plan availability.

The Medicare Prescription Drug Benefit Fact Sheet

This fact sheet includes the latest information and data about the Medicare Part D Prescription Drug Benefit, including current plan information, the standard benefit parameters, updates on additional low-income assistance, and the latest available enrollment data.

2014 Employer Health Benefits Survey

This annual Employer Health Benefits Survey (EHBS) provides a detailed look at trends in employer-sponsored health coverage, including premiums, employee contributions, cost-sharing provisions, and other relevant information. The 2014 EHBS survey finds average family health premiums rose 3 percent in 2014, relatively modest growth by historical standards.

Employer-Sponsored Family Health Premiums Rise 3 Percent in 2014

Average Annual Family Premiums Stand at $16,834, With Workers Contributing $4,823 Workers Now Face Deductibles Averaging $1,217, Up 47 Percent Since 2009 Menlo Park, Calif. – Average annual premiums for employer-sponsored family health coverage reached $16,834 this year, up 3 percent from last year, continuing a recent trend of modest increases,…

Medicare at a Glance

This fact sheet provides a basic overview of the Medicare program, including how it is financed, who is eligible, and what benefits are covered under the program. In addition, it describes supplemental health insurance, out-of-pocket spending by people on Medicare, and data on Medicare expenditures and financing.

Report Examines Trends in the Medicare Part D Plan Marketplace

A new comprehensive Kaiser Family Foundation report analyzes key trends that have shaped the Medicare Part D marketplace since the program launched nine years ago, providing a detailed assessment of changes in plan availability, enrollment, premiums and cost sharing in both private stand-alone drug plans, and Medicare Advantage drug plans.