The Menges Group puts out these great analyses and insights each month. And is kind enough to let us repost them for the MM audience. Check out themengesgroup.com to learn more about the work they do.
Attached are the March and April 2017 editions of the 5 Slide Series. The March edition tabulates the progression in Medicaid spending from 2012 – 2016, nationwide and with subtotals for states that did and didn’t adopt Medicaid expansion. One key statistic from this edition is that capitation rose from 25.7% of all Medicaid spending in 2012 to 48.7% in 2016 – the capitated model will likely represent the majority of Medicaid spending from 2017 forward.
The April edition provides Medicaid MCO financial performance statistics for 2015 – a compilation of 199 MCO financial statements. Collectively the industry earned a 2.4% operating margin on Medicaid business during 2015 with 71% of the MCOs achieving a positive margin and 29% experiencing a loss. An interesting finding was that the health plans’ percent operating margins were not correlated with plan size.
March 2017, Medicaid Expenditure Trends 2012-2016
April 2017, Medicaid MCO Financial Performance Overview, 2015