Medicaid health plans are saving states money, increasing access to services, improving quality of care and earning high satisfaction ratings from enrollees, according to a report released by America’s Health Insurance Plans.
The Lewin Group examined 24 studies to determine the savings achieved when states have implemented private Medicaid health plans.
“During these difficult economic times, Medicaid health plans provide states with tools that work and on which they can depend,” said Karen Ignagni, president and CEO of AHIP.
According to Lewin, health plans offer an opportunity for Medicaid programs to stretch their dollars and achieve cost savings without cutting eligibility, benefits or already-low provider payment levels as states look at ways to alleviate the economic pressure on their budgets.
According to the Lewin analysis:
- The studies strongly suggest that Medicaid health plans typically yield cost savings, ranging from one-half of 1 percent to 20 percent.
- The studies provide some evidence that Medicaid health plan savings are significant for the Supplemental Security Income (SSI) and SSI-related population while improving quality and value for beneficiaries.
- Medicaid health plans yielded noteworthy savings in pharmacies – a comparison of drug costs under FFS programs vs. Medicaid health plans in multiple states found that the costs per-member per-month (PMPM) were 10 percent to 15 percent lower for health plans than for FFS programs.
- The studies also suggest that health plans with responsibility for certain populations or services are especially likely to generate savings in a health plan delivery system while providing and coordinating comprehensive care.
- Medicaid health plans were found to have improved Medicaid beneficiaries’ access to services and earned high satisfaction ratings from enrollees in addition to containing costs.
“As stewards of public funds, quality accreditation ensures our state administrators that one of America's most financially vulnerable populations is receiving the quality care and service it needs and deserves,” said J. Mario Molina, MD, president and CEO of Molina Healthcare, Inc. “At Molina, we demonstrate this by ensuring all of our eligible health plans are quality accredited by NCQA.”
“Medicaid managed care works – it’s that simple,” said Daniel J. Hilferty, president and CEO of the AmeriHealth Mercy Family of Companies. “Medicaid recipients are among the most sick and vulnerable people in the United States. Using an integrated, proactive approach to healthcare, AmeriHealth Mercy has improved outcomes for our members and saved taxpayers millions of dollars. As the nation searches for high-quality, cost-effective health reform options, we offer a model that is proven to increase access to care and control costs.”
The study also noted that the FFS setting model makes coordination of care and cost-containment difficult, while health plans create savings opportunities without reducing eligibility and benefits.