PCMA: HHS Encourages State Medicaid Programs to Use more Generic Drugs
PCMA: HHS Encourages State Medicaid
Programs to Use more Generic Drugs
Washington, DC (Vocus/PRWEB) February 03, 2011
With Medicaid spending growth almost doubling over the past year, a new document released today by Health and Human Services (HHS) Secretary Kathleen Sebelius to all 50 governors encourages the use of lower-cost drugs – including generics – to help reduce Medicaid spending. The next step is for state Medicaid programs to stop paying pharmacies more than Medicare and other programs, said the Pharmaceutical Care Management Association (PCMA).
“By managing pharmacy benefits like other, more successful programs, Governors can cut billions in Medicaid without cutting benefits to patients or payments to doctors and hospitals,” said PCMA President and CEO Mark Merritt.
According to a new study by The Lewin Group, 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.
Most state Medicaid programs use an old-school fee-for-service approach in which state officials arbitrarily decide how much Medicaid will pay pharmacies. This approach exposes state governments to political pressure from the independent drugstore lobby to set artificially high payment levels. On the other hand, most non-Medicaid drug benefits programs – like those offered by Medicare, employers and unions – use independent, third party pharmacy benefit experts to negotiate more competitive rates with pharmacies. These programs also use cutting-edge, market-proven strategies to increase the use of generics.
Recent polling finds voters would rather reduce Medicaid spending by better managing pharmacy benefits than cut benefits for patients or payments to doctors and hospitals.
PCMA represents the nation’s pharmacy benefit managers (PBMs), which improve affordability and
quality of care through the use of electronic prescribing (e-prescribing), generic alternatives, mail-service pharmacies, and other innovative tools for 210-plus million Americans.
Follow PCMA on Twitter
Contact:
Charles Coté, 202-207-3605
###
©Copyright 1997-
, Vocus PRW Holdings, LLC.
Vocus, PRWeb, and Publicity Wire are trademarks or registered trademarks of Vocus, Inc. or Vocus PRW Holdings, LLC.
Four Healing Programs — Check Out The Affiliate Center
Four Healing Programs — Check Out The Affiliate Center
My simple exercises heal: High Blood Pressure, Vertigo, Dizziness, Fibromyalgia, Whiplash and Neck Injuries. Youll be redirected to my affiliate center to sign up.
Four Healing Programs — Check Out The Affiliate Center
States, Federal Government Could Save $30 Billion by Managing Medicaid Pharmacy More Like Medicare and Commercial Sector Programs
States, Federal Government Could Save $ 30 Billion by Managing Medicaid Pharmacy More Like Medicare and Commercial Sector Programs
Washington, DC (Vocus) December 6, 2010
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.
The study notes that Medicaid FFS pharmacy programs use fewer generic drugs and pay pharmacies higher dispensing fees and ingredient costs than other programs. The findings from this groundbreaking report challenge the assumption that Medicaid pharmacy can only reduce costs by cutting benefits, limiting eligibility, demanding deeper manufacturer rebates, or paying drugstores higher dispensing fees in exchange for more pricing transparency.
“Medicaid is one of the few pharmacy benefit programs that still relies heavily upon a fee-for-service approach. By operating more like Medicare and commercial market plans, Medicaid could increase the use of generics and save billions without cutting benefits,” said Pharmaceutical Care Management Association (PCMA) President and CEO Mark Merritt.
Currently, three-fourths of Medicaid pharmacy dollars are administered using a fee-for-service approach in which public officials play a role in determining how much to pay drugstores for each prescription filled (dispensing fees) and ingredient costs (the reimbursement for the cost of the actual drugs). The other one-fourth of Medicaid pharmacy is managed more like pharmacy benefits in the commercial sector, where third-parties use proven utilization management tools and negotiate pharmacy payments directly with chain drugstores and the drug wholesalers that represent independent pharmacies.
The Lewin study also finds that although state Medicaid programs pay widely varying Medicaid dispensing fees, these decisions seem largely unrelated to the level of ingredient cost reimbursements a state pays or the level of generic utilization a state achieves. For example, Texas pays the nation’s highest dispensing fees ($ 7.50) and New Hampshire pays the lowest ($ 1.75), but they both pay about the same for ingredient costs and generate similar rates of generic drug utilization.
Many Medicaid pharmacy discussions begin and end with the issue of the drug manufacturer rebates. However, the statutory and supplemental rebates paid to Medicaid by brand name drug manufacturers are determined separately from pharmacy dispensing fees and ingredient costs. This means that manufacturer rebates have no impact on the savings that more active management of dispensing fees and ingredient costs could achieve. Likewise, these savings also do not assume any additional cost sharing for Medicaid beneficiaries.
Key Findings
Savings Opportunities Exist In Four Key Areas
While Medicaid FFS programs and costs vary greatly state-by-state, The Lewin Group identified four key areas where pharmacy benefit management could generally be improved:
Generic Drug Dispensing: Medicaid FFS is less effective at encouraging the dispensing of generic drugs in place of brands. The generic dispensing rate in Medicaid FFS averages 68%, compared to an average 80% generic dispensing rate in Medicaid MCOs.
Dispensing Fees: At $ 4.81 per prescription, the national average dispensing fee that Medicaid FFS programs pay to retail pharmacies per each prescription is more than double the average dispensing fees paid by Medicare Part D payers, Medicaid MCOs, or health plans in the commercial sector.
Ingredient Costs: The rate at which retail pharmacies are reimbursed for the actual medication ingredients (pills, capsules, etc.) is also higher, on average, in Medicaid FFS programs than in Medicare Part D or the commercial sector.
Drug Utilization: The number of prescriptions dispensed per person is typically higher in Medicaid FFS programs than in Medicaid MCOs due to less effective controls on polypharmacy, fraud, waste, abuse, and other factors in the FFS setting.
Estimated Federal and State Medicaid Savings
If all state Medicaid programs used a market-based approach such that dispensing fees, ingredient costs, drug utilization, and generic drug dispensing were brought in-line with norms for Medicaid MCOs, Medicare Part D, and commercial payers, Lewin estimates that:
Combined federal and state savings to the Medicaid program would total $ 30.3 billion over the next decade.
Medicaid FFS prescription costs could be reduced by 14.8%.
Per member per month (PMPM) costs for Medicaid FFS pharmacy benefits could be reduced by $ 12 in 2011 under optimal management.
PCMA represents the nation’s pharmacy benefit managers (PBMs), which improve affordability and quality of care through the use of electronic prescribing (e-prescribing), generic alternatives, mail-service pharmacies, and other innovative tools for 210-plus million Americans.
The full report can be obtained at no charge at http://www.lewin.com/content/publications/Medicaid_Pharmacy_Savings_Report.pdf .
Follow PCMA on Twitter
###
©Copyright 1997-
, Vocus PRW Holdings, LLC.
Vocus, PRWeb, and Publicity Wire are trademarks or registered trademarks of Vocus, Inc. or Vocus PRW Holdings, LLC.
Categories: Medicaid Tags: billion, Commercial, could, Federal, Government, Like, Managing, Medicaid, Medicare, More, Pharmacy, Programs, Save, Sector, States
Helping Small Business With Employee Pension And Savings Programs
Helping Small Business With Employee Pension And Savings Programs
Business owners seeking to hire the best and brightest employees compete to offer great work environments, opportunities and benefits. But some small business owners in Canada who would like to offer pension and retirement savings plans to their employees are challenged by the complexity and costs of running such a program.
Already more than 50 per cent of Canadians working in the private sector have some sort of group retirement savings or investing program. Increasing opportunities for the balance requires some changes to Canada’s retirement savings system, according to the Canadian Life and Health Insurance Association.
“Business owners and operators recognize the enormous value of helping their employees save for their retirements, but many – particularly small business — are handcuffed by tax and administrative regulations that make running a program more expensive and time consuming,” says Frank Swedlove, president of the Canadians Life and Health Insurance Association Inc. “We need to make regulatory changes so that company pension plans become less complex and costly to operate. And we need to allow employers to band together in multi-employer plans that pool contributions and achieve efficiencies in cost and operations.”
Changing the law that requires that group pension programs only be offered by a single employer to its employees is one way to help employers. Doing so would allow for the creation of multi-employer pension plans where contributions are pooled and the administrative burden to each individual employer is reduced. Allowing for the creation of such multi-employer pensions plans would also let the self-employed participate in a pension program.
Employers recognize that providing a good company pension or group retirement saving program helps retain existing employees. Often they can improve the firms’ business reputation and help attract capable new employees. And, most importantly, they help give employees peace of mind.
Initiatives are underway to review Canada’s retirement savings programs. Capitalizing on many employers’ desire to help employees save, plus the efficiency of group programs, will play a big role in ensuring a successful system for future generations.
For over 25 years, News Canada has been providing the media with ready-to-use, timely, credible and copyright-free news content. Editors, broadcasters, web and video content providers rely on News Canada for newsworthy content to effectively enhance their websites, newspapers and broadcasts.
Article from articlesbase.com
Social Security Programs and Retirement Around the W…
Some recent social security retirement auctions on eBay:
1966 SOCIAL SECURITY RETIREMENT OR SURVIVOR BENEFITS BOOKLET US DEPT HEALTH
 | US $6.00 End Date: Friday Feb-10-2012 16:11:42 PST Buy It Now for only: US $6.00 Buy it now | Add to watch list |
Retirement, Pensions, and Social Security
 | US $24.53 End Date: Saturday Feb-11-2012 9:12:59 PST Buy It Now for only: US $24.53 Buy it now | Add to watch list |
Social Security and Retirement around the World (National Bureau of Economic Res
 | US $10.00 End Date: Tuesday Feb-14-2012 18:23:31 PST Buy It Now for only: US $10.00 Buy it now | Add to watch list |
Categories: Social Security Retirement Tags: Around, Programs, Retirement, Security, Social, W...
Social Security Programs and Retirement Around the W…
Social Security Retirement on eBay:
1966 SOCIAL SECURITY RETIREMENT OR SURVIVOR BENEFITS BOOKLET US DEPT HEALTH
| US $6.00 End Date: Friday Feb-10-2012 16:11:42 PST Buy It Now for only: US $6.00 Buy it now | Add to watch list |
Retirement, Pensions, and Social Security
| US $24.53 End Date: Saturday Feb-11-2012 9:12:59 PST Buy It Now for only: US $24.53 Buy it now | Add to watch list |
Categories: Social Security Retirement Tags: Around, Programs, Retirement, Security, Social, W...
Social Security Programs and Retirement Around the W…
Some recent social security retirement auctions on eBay:
1966 SOCIAL SECURITY RETIREMENT OR SURVIVOR BENEFITS BOOKLET US DEPT HEALTH
| US $6.00 End Date: Friday Feb-10-2012 16:11:42 PST Buy It Now for only: US $6.00 Buy it now | Add to watch list |
Retirement, Pensions, and Social Security
| US $24.53 End Date: Saturday Feb-11-2012 9:12:59 PST Buy It Now for only: US $24.53 Buy it now | Add to watch list |
Categories: Social Security Retirement Tags: Around, Programs, Retirement, Security, Social, W...
Social Security Programs and Retirement Around the W…
social security retirement eBay auctions you should keep an eye on:
1966 SOCIAL SECURITY RETIREMENT OR SURVIVOR BENEFITS BOOKLET US DEPT HEALTH
| US $6.00 End Date: Friday Feb-10-2012 16:11:42 PST Buy It Now for only: US $6.00 Buy it now | Add to watch list |
Retirement, Pensions, and Social Security
| US $24.53 End Date: Saturday Feb-11-2012 9:12:59 PST Buy It Now for only: US $24.53 Buy it now | Add to watch list |
Social Security and Retirement around the World (National Bureau of Economic Res
| US $10.00 End Date: Tuesday Feb-14-2012 18:23:31 PST Buy It Now for only: US $10.00 Buy it now | Add to watch list |
Categories: Social Security Retirement Tags: Around, Programs, Retirement, Security, Social, W...
Why You Should Consider Medical Office Administration Training and Medical Assistant Programs
Medical Office Administration Training prepares a person to efficiently handle various duties of medical offices. This course includes training for clerical as well as administrative positions to aid smooth and efficient running of the medical offices.
View full post on Most Popular Articles- Web Content RSS Feed Available
View full post on Medicare & Medicare Programs
Categories: Social Security Tags: Administration, Assistant, Consider, Medical, Office, Programs, Should, Training
Social Security Programs and Retirement Around the W…
social security retirement eBay auctions you should keep an eye on:
1966 SOCIAL SECURITY RETIREMENT OR SURVIVOR BENEFITS BOOKLET US DEPT HEALTH
| US $6.00 End Date: Friday Feb-10-2012 16:11:42 PST Buy It Now for only: US $6.00 Buy it now | Add to watch list |
Retirement, Pensions, and Social Security
| US $24.53 End Date: Saturday Feb-11-2012 9:12:59 PST Buy It Now for only: US $24.53 Buy it now | Add to watch list |
Social Security and Retirement around the World (National Bureau of Economic Res
| US $10.00 End Date: Tuesday Feb-14-2012 18:23:31 PST Buy It Now for only: US $10.00 Buy it now | Add to watch list |
Categories: Social Security Retirement Tags: Around, Programs, Retirement, Security, Social, W...
