Medicaid Pharmacy Carve-Outs: An OPEN MINDS Market Intelligence Report
State Medicaid programs use a mix of financing models to provide pharmacy services. Some states ‘carve-out’ all prescription drug pharmacy benefits, while others manage and/or finance select services only. Most states that contract with managed care organizations (MCOs) carve-in pharmacy benefits into their Medicaid contracts. One-third (29%) of states (plus D.C.) have carved-out of Medicaid pharmacy services from MCOs.
This report includes information on:
Comparative data and analysis of Medicaid pharmacy carve-out models in fee-for-service (FFS) and health plans
Comparative data and analysis of full and partial Medicaid pharmacy carve-outs . . .