Our Publications

Reports

Prescription Drug Adherence in Medicaid Managed Care
Oct 2014

Summary

Prescriptions for a Healthy America (P4HA) released a report by the Menges Group examining how Medicaid Managed Care Organizations (MCOs) are combatting prescription drug nonadherence.

The report highlights the efforts of several Medicaid plans and their best practices for improving prescription drug adherence

In commenting on the report’s release, Joel White, President of Prescriptions for a Healthy America made the following statement: “We believe this report is another important contribution to the growing body of evidence that finds medication adherence saves money and improves health.  What’s particularly exciting are the strategies outlined in the report can be adopted, today, by Governors across the country as they seek to improve Medicaid in ways that improve patient health, lower health costs and make the health system work better for everyday Americans. We encourage Governors to take notice.”

The report's lead author, Joel Menges, noted that: "While a large segment of the Medicaid population takes medication daily, the poverty population's life circumstances can diminish adherence in many ways.  The supportive innovations occurring in this arena are of benefit to all stakeholders."

Press Release

Full Report


State Policies Regarding Medicaid MCO Preferred Drug Lists
Apr 2014

Summary

The Association for Community Affiliated Plans (ACAP) enlisted The Menges Group to prepare a report on the ways in which state Medicaid agencies have opted to regulate Medicaid MCO PDL content.  Most states afford MCOs wide latitude in establishing their PDLs.  Conversely, a few states require MCOs to use the statewide Medicaid fee-for-service PDL, and a few others have taken a middle ground regulatory position.  The paper emphasizes that utilizing the lowest-cost, clinically effective medication is one of the most important avenues available to achieve Medicaid savings, and concludes that wide MCO latitude over PDL content is the most appropriate policy.  

Full Report


Analyses of NCQA Quality Ratings Among Medicaid Health Plans
Mar 2014

Summary

This report assesses Medicaid MCO quality scores as published annually by NCQA.  One of the report’s key findings is that there does not appear to be any relationship between Medicaid MCOs’ enrollment levels and their quality scores.  Another is that high-scoring plans are disproportionately concentrated in certain states – with these patterns often recurring (with different health plans in these same states) with regard to quality scores in the Medicare and private insurance sectors.  This leads us to conclude that some geographic areas are more conducive to high scores than others – and that MCOs making the same efforts in quality would likely obtain very different quality scores based on the market area in which they operate.  Our report also identifies the Medicaid MCOs with both large enrollment and high quality scores, the MCOs that stand out most favorably relative to average scores within their state, and the NCQA-accredited MCOs achieving the greatest improvements in their quality scores between 2010 and 2013.

Full Report


2013 SNP Alliance Profile and Advanced Practice Report
Feb 2014

Summary

The 2013 SNP Alliance Advanced Practice and Profile Report is the sixth edition of SNP performance findings for members of the SNP Alliance. The SNP Alliance is a national leadership group of 30 organizations that collectively represent more than half of current national SNP enrollment. The Menges Group authored the 2013 report. 

Executive Summary

Full Report


Medicaid Pharmacy Savings Opportunities: National and State-Specific Estimates
May 2013

Summary

This study explores how more efficient pharmacy benefits management—apart from drug manufacturer rebates—could save Medicaid an additional $74.4 billion over the next decade. These savings opportunities are compelling as the federal government and states strive to protect benefits and prepare for the Medicaid expansion authorized by the Affordable Care Act starting in 2014.

Executive Summary

Full Report