1 Medicaid Reporting and Trend Review Department of Social Services Division of Financial Services October 10, 2014

2 Medicaid Reporting and Trend Review  Expenditure Reporting Update New Legislative Report  Review of Major Medicaid Enrollment and Expenditure Trends Enrollment Trends Expenditure Trends Per Member Per Month Costs

3 Medicaid - New Legislative Expenditure Report  New Report Initiated at End of SFY 2014  Joint Effort with the Office of Fiscal Analysis and the Office of Policy and Management  Currently Shared with Committee Leadership (Appropriations & Human Services)

4 Medicaid - New Legislative Expenditure Report  Prior Medicaid Expenditure Report Category of Service Focus Did not Separate Expenditures by HUSKY Component (A,C, D) Prior to Net Funding of Medicaid

5 Medicaid - New Legislative Expenditure Report  Prior Format

6 Medicaid - New Legislative Expenditure Report  Enhancements in the New Report Format changes to traditional category of service section HUSKY A, C and D expenditures with monthly detail Quarterly enrollment, expenditures, and per member per month (PMPM) by HUSKY A,C,D

7 Medicaid - New Legislative Expenditure Report  Other Considerations Why quarterly versus monthly?  Trends more apparent and monthly variations are “normalized” Reporting is based upon date of payment consistent with general State expenditure reporting practices

8 Medicaid - New Legislative Expenditure Report  New Format – Category of Service Expenditures by Component (A, C, D)

9 Medicaid - New Legislative Expenditure Report  Added Quarterly Enrollment by Program Significant increase in HUSKY A and D coincides with Exchange implementation HUSKY A + 8.6% HUSKY D +52.5% HUSKY C enrollment remains steady

10 Medicaid - New Legislative Expenditure Report  Added Quarterly Expenditures Expenditures are generally consistent with enrollment increases Steady for HUSKY A since December Steady for HUSKY C Large increase for HUSKY D

11 Medicaid - New Legislative Expenditure Report  Added Quarterly PMPM Remarkably steady per member per month (PMPM) costs across the board with a sizable decrease in the PMPM for the HUSKY D population HUSKY C PMPM is clearly the highest at $2,398 PMPM with HUSKY A the lowest at $328 PMPM

12 Medicaid – Latest Trends in Enrollment Overall Medicaid enrollment has surpassed 753,000 This is an increase of 20% in the nine months since December 2013

13 Medicaid – Latest Trends in Expenditures As a result, Connecticut has experienced an increase in overall Medicaid spending The overall increase in CT Medicaid spending between SFY 2013 and SFY 2014 was 9.4%

14 Medicaid – Latest Trends in Per Member Per Month Costs The overall Medicaid per member per month trendline has been relatively stable PMPM decreased from SFY 2012 to 2013 by -0.7% PMPM increased from SFY 2013 to 2014 by 1.8% Average two year growth rate of approximately 0.5%

15 Medicaid – Latest Trends Expenditures & Enrollment In this side-by-side review, enrollment growth can be clearly seen as exceeding overall expenditure growth trends For this period, the enrollment growth trend was 20%, compared to the trend in overall expenditure growth which was 13.6%

Medicaid – Composition of Enrollment HUSKY C HUSKY D HUSKY A

Medicaid – Composition of Expenditures HUSKY D HUSKY C HUSKY A Enrollment: HUSKY A 65.6%; HUSKY C 13.6%; HUSKY D 20.7%

Closing  National Medicaid trend information - latest CMS Actuarial report cites national PMPM in the range of 5% for FFY 2013  Favorable cost trends - combination of efforts and factors  Costs carefully managed while access and improved outcomes have also been achieved