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Our "Understanding Health Insurance 101" guide will provide you with key insights on Virginia's Health Insurance landscape.
Understanding Health Insurance 101
The "Understanding Medicaid Managed Care in Virginia" document will provide you with an overview of Medicaid in Virginia.
Understanding Medicaid Managed Care in Virginia
Assessment of the Pharmacy Carve-In Model for Virginia’s Medicaid Program:
This report explores the fiscal and programmatic impacts that a switch to a prescription drug carve-out model, where the pharmacy benefit would be managed under a single-payer system within Medicaid using the fee-for-service payment methodology, would have on Virginia’s Medicaid program (Cardinal Care). Our key recommendations for the Medicaid program include preserving the current pharmacy carve-in, preserving the common core formulary (i.e., the preferred drug list), enhancing reimbursements to critical access pharmacies, increasing MCO policymaking representation, and exploring potential revisions to capitation rates for the pharmacy component.
Virginia-Pharmacy-Carve-Out-Assessment_final-002.pdf
Medicaid managed care: Improving outcomes, enhancing access and managing costs
Medicaid Managed Care Organizations (Medicaid MCOs) provide value to consumers, state partners and providers by increasing access to high-quality care, centering the consumer experience, managing costs to ensure people get the right care when and where they need it across the health care system and providing benefit and budget predictability. This approach ultimately enhances the health care experience for individuals facing economic and social barriers.