Insurers: New Drugs, Devices Should Be Factored Into Medicaid Rates

Actuaries should consider the potential impact of potential breakthrough drugs or devices on spending when establishing the capitation rates for Medicaid managed care plans, health insurance stakeholders tell the trade group representing the nation's actuaries. The insurers' concerns come at a time when managed care plans are trying to get states to reimburse them for spending on the high-cost Hepatitis C drug Sovaldi, which came onto the market after states and plans had already negotiated 2014 rates. Industry stakeholders made...