Analysis of Pharmacy Benefit Managers' Impact on Medicaid Drug Pricing
Release: December 21, 2022
An Analysis of Pharmacy Benefit Managers' Impact on Medicaid Drug Pricing provides some insights into the question of how decision makers can best incorporate Pharmacy Benefit Managers ("PBMs") into the management of Medicaid and CHIP. The report summarizes how PBMs work in practice at the state level to contain retail prescription drug costs in Medicaid programs, and to the extent relevant, how the “Managed Care Organizations (“MCOs”) contract with various state governments to administer Medicaid and CHIP benefits and services. Additionally, the report provides a brief explanation of how the retail prices for prescription drugs are determined at the state level for Medicaid programs in the Managed Care/PBM setting —and how that differs from the traditional Fee-for-Services or FFS setting.
The report also provides a national snapshot of the PBM's impact on drug pricing nationally, and then delves into the impact of PBMs on prescription drug costs in Medicaid and CHIP programs for five states: Illinois, West Virginia, Louisiana, Missouri, and Florida. West Virginia and Missouri are examples of states that use a pharmacy benefit “carve out,” which means some or all Medicaid prescription drug benefits are not included in the state’s respective managed care contracts. Illinois, Florida, and Louisiana were selected as states that rely on a pharmacy benefit “carve in,” which means Medicaid prescription drug benefits are for the most part included in the applicable managed care contracts.
Cook County's Budget: Long-Term Imbalance Leads to New Pain for Vulnerable Residents
Release: November 14, 2017
On October 11, 2017, the Cook County Board of Commissioners voted to repeal a penny-per-ounce tax on sweetened beverages. The FY2018 budget presented by Cook County Board President Toni Preckwinkle had relied on the sweetened beverage tax to cover just over $200 million of the county's projected expenditures on services.
Illinois FY2013 General Fund Enacted Budget Analysis
Release: August 2, 2012
This Report provides an analysis of the enacted FY2013 General Fund budget.
Analysis of the FY2013 Proposed Illinois FY2013 General Fund Budget
Release: April 8, 2012
This Report provides an analysis of the FY2013 General Fund budget proposed by Governor Pat Quinn on February 22, 2012.
Medicaid's Financing Structure Benefits Illinois by Pulling Federal Funds into the State's Economy
Release: March 31, 2010
A Fact Sheet on the impact Medicaid has on Illinois' economy.