Greater use of PBM Tools Will Also Save the Federal Government More than $212 Million
WASHINGTON, Oct. 11, 2012 /PRNewswire-USNewswire/ -- Governor Andrew Cuomo's decision to reform New York's Medicaid pharmacy program using proven pharmacy benefit management (PBM) tools is projected to save the state $425 million in 2012, according to a new study from Special Needs Consulting Services (SNCS) released today by the Pharmaceutical Care Management Association (PCMA).
New York is one of many states exploring new ways to eliminate wasteful Medicaid spending without reducing patient access to quality care. To this end, in January 2011, Governor Cuomo created a Medicaid Redesign Team (MRT) with a goal of "ending the state's Medicaid fee-for-service system and replacing it with a comprehensive, high-quality and integrated care management system that will lower costs and improve health outcomes."
"Governor Cuomo has found a way to reduce millions in wasteful Medicaid pharmacy spending without reducing the number of enrollees or the quality of their benefits," said PCMA President and CEO Mark Merritt. "This could be a bellwether for other states."
Major findings from the new study include:
Click here to read the study
Increased savings in Medicaid pharmacy are driven from four key areas:
The passage of the Affordable Care Act (ACA) in 2010 allowed states to collect statutory manufacturer rebates on prescriptions reimbursed by capitated Medicaid MCOs. Before this, many state Medicaid programs resisted integrating pharmacy benefits and PBM tools for fear of losing access to those rebates. Since 2010, many states have revisited the idea of integrating modernized pharmacy benefits.
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.
SOURCE Pharmaceutical Care Management Association