Medicaid is turning 60 this year and there are significant questions about its sustainability. Medical costs went up, enrollment went up, but funding stayed stagnate. More than 79 million Americans depend on Medicaid and CHIP for essential coverage, functioning as a health safety net for seniors, families, individuals with disabilities, and children who fall below 138% of the Federal Poverty Level (FPL). Current discussions of Medicaid’s future center around spending cuts but there is wide disagreement about how with one noted exception: all parties agree that eliminating fraud and waste is important to Medicaid’s sustainability.
Reducing Waste
The biggest challenge to effectively managing Medicaid’s budget is lowering spending without compromising essential care. While there are few cost-saving measures that do not come at the expense of patient well-being, Medicaid can look to innovative solutions that reduce waste, optimize resource allocation, and promote smarter healthcare decisions.
Since one of the largest drivers of Medicaid spending is prescription drug costs, addressing waste and inefficiencies—such as prescribing expensive brand-name drugs when equally effective lower-cost alternatives exist—could save billions of dollars. HealthTech companies like RazorMetrics offer smart, evidence-based strategies that reduce unnecessary spending while keeping patients on safe, effective medications.
For example, RazorMetrics helps Medicaid programs optimize their prescription drug spending by:
- Identifying lower-cost medication alternatives that provide the same therapeutic benefits.
- Empowering prescribers with actionable insights to make cost-effective prescribing decisions.
- Engaging patients to ensure they understand their options and the impact of medication choices on affordability and outcomes.
Cost-Containment for Medicaid
As discussions continue about Medicaid’s future, finding a balance between cost control and quality care will remain a priority. Solutions that focus on efficiency—rather than benefit reductions—offer a path forward that protects access to care while addressing financial sustainability. By leveraging data, HealthTech companies like RazorMetrics can streamline the prescription experience that will let Medicaid contain drug costs and continue to provide America’s vital health safety net.
Interested in learning how RazorMetrics can support Medicaid and other healthcare programs in reducing costs while improving outcomes? Contact us today to explore your solution options.
