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Previous Research

Welfare Leavers and Medicaid Dynamics: Five States in 1995. Previous Research

Concerns about Medicaid enrollment patterns are not new. Although Medicaid enrollment of children and their parents increased by just over 60 percent during the period from 1987 to 1995,
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Introduction

Welfare Leavers and Medicaid Dynamics: Five States in 1995. Introduction

State welfare caseloads have been declining at an unprecedented rate since 1994, partly as a result of state and federal welfare reform efforts and partly because of a strong economy. From a peak of 14.2 million recipients in 1994, by 1998 monthly welfare enrollment had dropped more than 40 percent to an average of 8.3 million recipients. Medicaid
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Findings

Welfare Leavers and Medicaid Dynamics: Five States in 1995. Findings

Study findings add to the body of evidence that declines in the welfare caseload which began in 1995 are likely to have a noticeable effect on state Medicaid programs, in terms of overall enrollment, caseload mix, and per capita expenditure levels. The findings also point to problems of continuity in Medicaid enrollment, which may be contributing
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Executive Summary

Welfare Leavers and Medicaid Dynamics: Five States in 1995. Executive Summary

State welfare caseloads have been declining at an unprecedented rate since 1994, partly as a result of state and federal welfare reform efforts and partly because of a strong economy. Medicaid enrollment for children and their parents has been shrinking as well (although less so than welfare), in spite of state efforts to expand their Medicaid eli
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Welfare Leavers and Medicaid Dynamics: Five

Welfare Leavers and Medicaid Dynamics: Five States in 1995

By Marilyn Ellwood & Carol Irvin Mathematica Policy Research, Inc. 50 Church Street, Fourth Floor Cambridge, MA 02138 April 14, 2000
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Beyond the Water's Edge: Charting the Course

Beyond the Water's Edge: Charting the Course of Managed Care for People with Disabilities - Conference Resource Book

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Descriptive Study of Three Disability Competent

Descriptive Study of Three Disability Competent Managed Care Plans for Medicaid Enrollees

From: Descriptive Study of Three Disability Competent Managed Care Plans for Medicaid Enrollees
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Endnotes

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. Endnotes

1 - Claritin, Premarin, Zantac, Prozac, Trimox, Prilosec, Lanoxin, Hydrocodone w/APAP, Norvasc, Lipitor, Furosemide, Synthroid, Coumadin, Vasotec, Atenolol, Lasix, Triamterene/HCTZ, Cardizem CD, Hydrochlorothiazide, Zestril, Prednisone, K-Dur, Zocor, Procardia XL, and Glyburide. 2 - Analysis using a different set of drugs might yield different r
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Cash Share of the Market

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. Cash Share of the Market

Cash payments have accounted for a declining share of the retail market for prescription drugs, as noted in Chapter 3. The share of prescriptions for which the purchaser pays in cash at the time of the transaction has declined from 63 percent in 1990 to 25 percent in 1998. 4 One possible explanation for some of the differences just observed could
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Prescription Drug Prices

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. Prescription Drug Prices

Given the national nature of many of the major players in the prescription drug market—drugs are produced by national manufacturers, distributed through mostly national PBMs and in many cases through national pharmacy chains—we might not expect to see large price differences by region. We would expect to see small differences based on local pr
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Utilization and Spending

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. Utilization and Spending

In Chapter 2, various data were presented that showed spending differences between individuals with and without insurance coverage for prescription drugs. Here we consider those same comparisons within regions. Because size of prescription may vary due to differences in local medical practice patterns and variations in state Medicaid regulations o
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Coverage

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. Coverage

Table C-1 shows variation in coverage levels by region using MEPS data on drug coverage for the civilian, noninstitutionalized population. The highest coverage rates are in the Midwest and Northeast with the lowest coverage rate in the South. The pattern observed is similar to analyses of general health insurance coverage elsewhere.
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Appendix C. State and Regional Variations

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. Appendix C. State and Regional Variations

One area of inquiry that is not discussed in the main report is regional and state variation. Preliminary analysis from several different sources suggests that there are substantial regional and state variations in spending and utilization of prescription drugs and in prices faced by consumers. At this point, we can observe some differences, but w
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Endnotes

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. Endnotes

1 - The one exception was Medicare HMO coverage, which was identified through HCFA(now known as CMS) enrollment records. 2 -The MEPS estimates are adjusted for two reasons. First, the adjusted MEPS estimates can be directly compared to the MCBS estimates. Second, the unadjusted MEPS estimates would overstate the percentage of beneficiaries who h
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MEPS Price Data

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. MEPS Price Data

It should be emphasized that, while some aspects of the MEPS method of assigning coverage may introduce potential biases into its estimates of relative utilization by covered and noncovered beneficiaries, there is no reason to believe that chapter 3 overstates the price differences for the two groups. It was noted earlier that, while MEPS treats a
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Effects of Coverage Estimates

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. Effects of Coverage Estimates

As was discussed earlier, MEPS produces higher estimates of Medicare beneficiaries who had drug coverage than MCBS for three basic reasons. First, MEPS assigns coverage to larger numbers of people who did not report having drug coverage but who were found to have a third-party payment for a prescription. Second, MEPS treats all Medicaid and Medica
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Spending Estimates

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. Spending Estimates

MEPS data for 1996 indicate that 27 percent of people who used prescription drugs paid for those drugs in full at the time they received them. 3 Most people with public or private coverage pay only a copayment or coinsurance amount. (Exceptions include people who have not yet met a deductible or who have exceeded a cap on their coverage and peopl
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Utilization Estimates

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. Utilization Estimates

The MCBS and the MEPS household component both involve multiple rounds of interviews with each respondent. In each interview, the respondent is asked about services used in the period since the last interview. MEPS separately surveys pharmacies named by respondents, and can thus supplement the information gathered in the household survey. Because
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Estimates of Utilization and Spending

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. Estimates of Utilization and Spending

Gathering information through household surveys about prescription drug use and spending is much more difficult than for some other kinds of medical services. While most people can readily recall, for example, whether they were hospitalized in the last year and for what reason, filling a prescription is not so memorable an event. People who filled
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Establishing Coverage

Report to the President: Prescription Drug Coverage, Spending, Utilization, and Prices.. Establishing Coverage

Both the MCBS and the MEPS household survey asked participants if they had prescription drug coverage. MEPS had a second source of information: for respondents who named the pharmacies they used and gave interviewers permission to contact the pharmacy (the pharmacy follow-back), it was possible to determine the sources of payment for prescriptions

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