Medicaid MCOs: Contracting Landscape and Manufacturer Competitive Assessment

Medicaid MCOs: Contracting Landscape and Manufacturer Competitive Assessment

Highlights of the report:
Download a PDF of these Highlights

As the managed Medicaid plan segment continues to expand, establishing meaningful partnerships and/or collaborations with Medicaid MCOs remains critical to maintain market access. HIRC's report, Medicaid MCOs: Contracting Landscape and Manufacturer Competitive Assessment, reviews Medicaid plan pharmacy and medical directors' evaluation of manufacturers and focuses on trends in contracting. The report addresses the following questions:

  • Which manufacturers are most often nominated as Medicaid MCOs' overall "Partner of Choice"?
  • Which manufacturers lead in Medicaid executives' evaluation of willingness to offer supplemental rebates, and in which therapeutic areas?
  • Which manufacturers lead in MCOs' evaluation of quality of programs and resources?
  • Which contract types are most frequently available across traditional, specialty, and oncology products? Which are perceived as the most valuable?
  • What types of programs and resources are Medicaid MCOs most interested in?

Key Finding: Respondents perceive flat access rebates tied to preferred position contracts as the most frequently available contract type across medications, followed by price protection contracts.

AbbVie Leads as Top Partner of Choice Across Medicaid MCOs' in 2021. AbbVie is most often nominated as Medicaid MCOs' overall partner of choice in 2021, followed closely by GlaxoSmithKline and Lilly. The primary factors driving partner of choice nominations include account management support/personnel, willingness to contract, and quality of programs/resources. 

The full report provides a complete listing of Medicaid executives' overall partner of choice nominations across manufacturers.

MCOs Report Highest Interest in Engaging in Risk/Outcomes-based Contracting for Diabetes Medications. When asked to consider and rate seventeen therapeutic areas, Medicaid MCO key decision-makers report the highest interest in engaging in risk/outcomes-based contracting arrangements for type 2 diabetes medications, followed by hepatitis C and oral oncology medications.

Reducing Readmissions & Population Health Management Among Medicaid MCOs' Most Urgent Need to Partner. Medicaid respondents were asked to consider a list of ten pharmaceutical manufacturer support offerings and select one that represents their organization's most urgent need for a manufacturer partner. Panelists most often select support in reducing hospital readmissions and population health management as the most urgent need to partner, followed by medication adherence support.

Research Methodology and Report Availability. In October 2021, HIRC surveyed 32 Medicaid managed care organization (MCO) pharmacy and medical directors from national, regional, and BCBS plans. Online surveys and follow-up telephone interviews were used to gather information. The complete report, Medicaid MCOs: Contracting Landscape and Manufacturer Competitive Assessment, is available now to HIRC’s Managed Markets subscribers at www.hirc.com.

Download a PDF of these Highlights

Download Full Report (Subscribers only) >