Medicaid Managed Care Trends Revealed Through Expenditure Data
Explore the latest trends in managed care through Medicaid expenditure data, showcasing utilization patterns, expenditure growth, and service category breakdowns. Stay updated with the upcoming Medicaid Managed Care Expenditures Dashboard for comprehensive insights.
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Presentation Transcript
UTILIZATION AND OTHER TRENDS IN MANAGED CARE March 11, 2020 Ellen Montz, Chief Deputy, Chief Health Economist
Trends in MCO Expenditures MCO expenditures by program $2,500 Millions Expansion $2,000 $831 $755 $1,500 $523 $440 $1,119 $1,099 $1,000 $1,021 $1,015 $500 $0 Jul - 18 Oct - 18 Jan - 19 Apr - 19 CCC Plus Medallion 2
Medicaid Expansion Expenditures Quarterly MCO Expenditures Following Expansion $2,500 Millions $2,000 $1,500 $1,000 $500 $0 Jul-18 Oct-18 Jan-19 Apr-19 Jul-19 Base Medicaid Expansion 3
Medicaid Expansion Expenditures MCO Expenditures for Expansion Members Grows with Enrollment 350,000 $400,000,000 $350,000,000 300,000 $300,000,000 250,000 $250,000,000 200,000 $200,000,000 150,000 $150,000,000 100,000 $100,000,000 50,000 $50,000,000 0 $0 Jan-19 Feb-19 Mar-19 Apr-19 May-19 Jun-19 Jul-19 Enrollment CCC Plus Expenditures Medallion 4 Expenditures 4
Expenditures by Service Category Expansion Behavioral Health General Medical Services Long Term Care 5
Medicaid Expansion Expenditures Top 5 Categories of Expenditures Expenditures by Categories of Service for Expansion Members Pharmacy, $25,400,000 Inpatient Hospital, $21,100,000 Outpatient Hospital, $18,700,000 Physician Services, $11,100,000 Community Mental Health Services, $7,400,000 6
Non-Expansion Expenditures Top 5 Categories of Expenditures Expenditures by Categories of Service for Non-Expansion Members Nursing Facilities, $223,800,000 Home and Community- Based Waiver Services, $215,500,000 Outpatient Hospital, $185,600,000 Pharmacy, $137,400,000 Inpatient Hospital, $110,300,000 7
Utilization and Expenditure Dashboard Updates Medicaid Managed Care Expenditures Dashboard Will be published mid-April Updated quarterly Content includes: MCO expenditure by service category, by program Future content includes: Breakdowns by population PMPM estimates https://www.dmas.virginia.gov/#/accessdashboard 8
Medicaid Expansion Utilization to Date Expansion members currently enrolled: 387,045 Percent of Medicaid Expansion members utilizing services Expansion members treated for chronic conditions 100% 90% 6,525 88% 80% 25,369 70% 72% 68% 8,534 60% 11,562 50% 28,865 40% 30% 51,973 20% 10% 0 20,000 40,000 ARTS Asthma High Blood pressure 60,000 Cancer COPD Diabetes 0% Any Service Office visit Prescription 9
Utilization and Expenditure Dashboard Updates Medicaid Expansion Access Dashboard Published January 8, 2020 Updated on 1st and 15th of the month Changes: Will move to a monthly schedule (end of month) beginning in April https://www.dmas.virginia.gov/#/accessdashboard 10
