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September, 2017

A Small Number of Medicaid MCOs and PBAs Control Most of the Pharmacy Benefit

Medicaid Rx Payers | Research Released August 2017

A Small Number of Medicaid MCOs and PBAs Control Most of the Pharmacy Benefit. The top eight MCOs now represent over half of all managed Medicaid. Three plans cover close to one third of all managed Medicaid. 

Magellan remains the gatekeeper for nearly 28% of the Medicaid pharmacy benefit. PBAs administer to similar pharmacy lives in 2016, totaling over 14 million in 2016. 

Managed medicaid remains controlled by few MCOs

Download the research slide 

 

These and other findings can be found in Health Strategies Group’s recently released research Medicaid MCO and PBA Profiles and Assessments. 

Key questions answered in this research:

  • Who are the leading managed Medicaid MCOs and PBAs?
  • What changes are MCOs and PBAs making to the delivery of care in Medicaid?
  • What are the strengths and weaknesses of each organization?
  • What partnership and engagement opportunities exist for biopharmaceutical companies?

Download Research Agenda

 

Visit our Medicaid Rx Payers webpage to learn more about this research.

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