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Questions Surrounding Anti-diabetic GLP-1s in Medicaid
A quantitative analysis of GLP-1 utilization and cost, with a particular emphasis on anti-diabetic indicated GLP-1s in a sample of Medicaid managed care programs.
Reentry for justice-involved individuals: A road map for state Medicaid agencies pursuing an 1115 demonstration
Recent changes to federal Medicaid policy have afforded states new flexibilities to improve access to and continuity of healthcare services for individuals as they reenter the community post-incarceration.
Final Rule CMS-2439-F: Medicaid medical loss ratio standards
Essential insights for state Medicaid agencies.
How will Medicaid Pay for Cell and Gene Therapies
Amid the development of new cell and gene therapies, we present some strategies that states have used to control costs and risk among their MCOs.
Medicaid managed care financial results for 2023
This research report offers reference and benchmarking information for certain key metrics used in the routine analysis of Medicaid financial performance of managed care organizations (MCOs).
CY 2025 Medicare Advantage Rate Announcement and final rule: What do Medicaid leaders need to know?
In April, the Centers for Medicare and Medicaid Services (CMS) released the 2025 Medicare Advantage (MA) and Part D final rule and MA rate notice.
Key considerations in developing Medicaid VBP strategies
This white paper is part of a Milliman series focused on considerations for state Medicaid agencies interested in increasing the adoption of VBP in their states.
Texas Medicaid managed care financial results for Q3 SFY 2023
The Texas Health and Human Services Commission publishes statutory financial statistical reports (FSRs) for managed care organizations contracting with the state to provide benefits under Medicaid and the Children’s Health Insurance Program (CHIP).
Average Manufacturer Price cap removal: Implications for state Medicaid programs
As a new federal law, effective in 2024, removes a cap on manufacturers' drug rebate amounts, we explore the implications for state Medicaid programs.
State-directed payment considerations for the CMS Medicaid and CHIP Managed Care Access, Finance, and Quality proposed rulemaking
We review the essentials for states to consider regarding the proposed changes by CMS for Medicaid and Children’s Health Insurance Program Managed Care Access.
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