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State-by-State Analysis Shows that Medicaid Pays Higher Pharmacy Rates, Uses Fewer Generics than Other Programs
WASHINGTON, Dec. 6, 2010 /PRNewswire-USNewswire/ -- A new study from The Lewin Group finds that Medicaid pharmacy could save more than $30 billion over the next decade by transitioning from the current approach used by state Medicaid fee-for-service (FFS) programs to the more efficient approaches used by Medicare Part D plans, Medicaid managed care organizations (MCOs), and the commercial sector, including typical state employee plans.
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The recent recession resulted in companies in the banking, housing and other industries merging. It also is happening in the not-for-profit sector.
After two years of research and negotiations, two St. Charles County not-for-profits formally merged last week. Community Living Inc. and Family Support Services both serve the developmentally disabled, CLI's services and programs before the merger were focused on adults while FFS specifically geared its programs to young people ages 12 to 21.
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Most Oppose Cutting Benefits for Patients or Payments to Doctors, Hospitals
WASHINGTON, Dec. 10, 2010 /PRNewswire-USNewswire/ -- Voters would rather reduce Medicaid spending by better managing pharmacy benefits rather than cutting benefits for patients or payments to doctors and hospitals, according to a new poll commissioned by the Pharmaceutical Care Management Association (PCMA).
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WASHINGTON, Jan. 19, 2011 /PRNewswire-USNewswire/ -- A new study by The Lewin Group finds that the Mississippi Medicaid program could save $65 million over the next decade by managing pharmacy benefits more like state employee plans, Medicare, Medicaid managed care plans, and commercial-sector employer plans. Voters would also prefer to reduce Medicaid spending by better managing pharmacy benefits rather than cutting benefits for patients or payments to doctors and hospitals, according to a new poll from Ayres, McHenry & Associates, Inc.
Unlike Medicaid fee-for-service (FFS) programs, most health plans use third-parties to improve generic utilization and negotiate pharmacy payments directly with chain drugstores and the drug wholesalers that represent independent pharmacies.
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Persistent depression can be a disabling condition (Penninx, Leveille, Ferrucci, van Eijk, & Guralnik, 1999), but it can become increasingly so in the...
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Thirteen states can realize over $11 billion savings in Medicaid over 10 years while strengthening their coordinated care models
WASHINGTON, Jan. 20, 2011 /PRNewswire-USNewswire/ -- A study sponsored by Medicaid Health Plans of America (MHPA) released today by The Lewin Group finds large-scale savings can be achieved if 13 states abandoned their current pharmacy carve-out model in favor of a carve-in approach -- including prescription drugs in health plans' capitation payments. In "Projected Impacts of Adopting a Pharmacy Carve-In Approach Within Medicaid Capitation Programs," Lewin researchers reported that these states where prescription drugs are not part of the Medicaid capitated rate but instead are "carved- out" - paid separately through the traditional fee-for-service (FFS) progr...
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FDA-cleared FFS is a less-invasive alternative to pedicle screws used in one- and two-level fusions
"FFS represents our Company's first potential 'h...
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BOWIE, Md., July 28 /PRNewswire/ -- MedAssurant Inc., a leading provider of data-driven healthcare solutions, announced that research from a major study by America's Health Insurance Plans (AHIP) was presented in Washington D.C. today featuring MedAssurant's data and analytics. The results were presented by AHIP alongside executives from Aetna, Humana, Tufts and United in a session entitled "Reducing Preventable Hospital Readmissions in Medicare.
The study utilized MedAssurant's Medical Outcomes for Research on Economics and Effectiveness Registry (the MORE2 Registry(TM)) to compare Medicare Advantage (MA) enrollees' rehospitalization rates with results from a 2004 study by Dr. Stephen Jencks et al. of Medicare's traditional fee-for-service (FFS) program (NEJM, 2009). Using pooled, de-...
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The updated published HEDIS measures reveal that the 2006 childhood immunization rate II for Community Care of North Carolina (CCNC) Medicaid (81.7%) exceeds the 2006 North Carolina Medicaid fee-for-service (FFS) rate (75.0%), national 2006 HEDIS benchmark (70.4%), and almost reaches the 2006 HEDIS 90th percentile benchmark (82.7%; North Carolina Division of Medical Assistance, 2009).