Medicaid managed care prescription use and cost savings.
OBJECTIVE
To evaluate the impact of Medicaid managed care (MC) enrollment on prescription use and costs.


METHODS
Retrospective, cross-sectional analysis of claims submitted over a 6-month period.


METHODS
Ohio Medicaid.


METHODS
Stratified, random selection of 2,932 MC and 1,335 fee-for-service (FFS) recipients.


METHODS
Dependent variables were the probability of any prescription use and 6-month prescription counts and costs. Independent variables included age, plan enrollment (MC or FFS), county enrollment status (mandatory or voluntary), presence of a chronic comorbidity, and any outpatient medical visit.


RESULTS
After adjusting for comorbidities and outpatient medical visits, plan enrollment effects depended on age. FFS enrollees 8 to 12 and 12 to 18 years old were less likely (adjusted odds ratios 0.56 and 0.58, respectively) to receive a prescription, while enrollees over 30 years of age were 2.98 times more likely to receive a prescription. Among prescription users, level of use and costs were consistent across all ages for MC enrollees. FFS enrollees had 25% to 218% higher levels of prescription use than MC enrollees, depending on age. Prescription costs were 8% lower for FFS enrollees ages 4 to 8 but higher for all enrollees in other age groups (range, 22% to 311% higher).


CONCLUSIONS
Prescription use and costs were lower for Medicaid MC enrollees than they were for patients in traditional FFS plans. Further research is needed to examine the quality of care for both FFS and MC enrollees.
Shireman
Theresa I
TI
School of Pharmacy, University of Kansas, Lawrence 66045-7582, USA. tshireman@rx.pharm.ukans.edu
Hornung
Richard W
RW
Ho
Mona
M
Moomaw
Charles J
CJ
Jang
Raymond
R
D000293:Adolescent; D000328:Adult; D000367:Age Factors; D002648:Child; D002675:Child, Preschool; D017046:Cost Savings; D016527:Drug Costs; D011307:Drug Prescriptions / Q000191:economics*; D006801:Humans; D007223:Infant; D008329:Managed Care Programs / Q000191:economics*; D008484:Medicaid / Q000191:economics*; D009820:Ohio; D012189:Retrospective Studies