White Paper

The Effective Medicaid Pharmacy Program: A White Paper for Medicaid Directors and State Agency Personnel

Commonwealth Medicine is now ForHealth Consulting at UMass Chan Medical School. More information available here. This content has not been updated with the new name.

In June 2019, the New England States Consortium Systems Organization (NESCSO) and Commonwealth Medicine jointly released a white paper titled The Effective Medicaid Pharmacy Program. Through information compiled from stakeholder interviews and an environmental scan, this brief paper reviews components of an effective Medicaid pharmacy program and provides practical information for Medicaid programs and state leadership. An effective Medicaid pharmacy program provides members with access to medically necessary medications that are cost-effective, aligned with best clinical practice, and provided in a transparent environment. It is important to consider a program’s administrative structure, pharmacy benefit delivery system, and influence of external factors in the achievement of these goals.