Tag Archives: UT

Market Overview PDF

Download NowUtah_060524.pdf

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UT Medicaid ACO Contracts, 2017-24

1. UT ACO Contracts SFY 2024
2-5. UT ACO Contracts, SFY 2023
6-9. UT ACO Contracts, January 1, 2018 – December 31, 2022
10-17. UT ACO Contracts, January 1, 2017 – December 31, 2017

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UT Medicaid Annual Reports, FY 2014-18

Utah Medicaid and CHIP Annual Reports, SFY 2014-18

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UT Medicaid Managed Care Enrollment is Up 24.4%, Jun-20 Data

Medicaid managed care enrollment in Utah was up 24.4% in June 2020 compared to year-end 2019 after a 4.5% decrease in 2019, a 5.3% decrease in 2018, a 3% decrease in 2017, and a flat showing in 2016. The state implemented a full Medicaid expansion in January 2020, replacing a partial expansion up to 100% of the federal poverty level that began in April 2019. The state also implemented the Utah Medicaid Integrated Care (UMIC) program effective January 1, 2020. This program manages physical and behavioral benefits through integrated managed care plans in five counties. Adult Expansion Medicaid members in Davis, Salt Lake, Utah, Washington, and Weber counties are required to enroll in a UMIC plan.

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UT SNP Membership at 7,406, Mar-20 Data

Utah had 7,406 Special Needs Plan members as of March 2020.

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MLRs Average 86.6% at UT Medicaid MCOs, 2019 Data

Average medical loss ratio (MLR) among three Utah Medicaid managed care organizations (MCOs) was 86.6% in 2019. Per member per month premiums among the three plans averaged $292. Comparable data for Healthy U Medicaid was not available.

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UT Medicaid to Pay Claims for Uninsured Seeking COVID-19 Tests

The Salt Lake Tribune reported on June 1, 2020, that Utah Medicaid will begin covering COVID-19 tests for uninsured patients, effective June 1. Patients must be uninsured and meet citizenship and Utah residency requirements to receive coverage. Read More

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UT Medicaid Managed Care Enrollment is Up 20.6%, May-20 Data

Medicaid managed care enrollment in Utah was up 20.6% in May 2020 compared to year-end 2019 after a 4.5% decrease in 2019, a 5.3% decrease in 2018, a 3% decrease in 2017, and a flat showing in 2016. The state implemented the Utah Medicaid Integrated Care (UMIC) program effective January 1, 2020. This program manages physical and behavioral benefits through integrated managed care plans in five counties. Adult Expansion Medicaid members in Davis, Salt Lake, Utah, Washington, and Weber counties are required to enroll in a UMIC plan.

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UT Medicaid Pharmacy Point of Sale System RFP, May-20

Utah Department of Health Medicaid Fee-for-service Pharmacy Point of Sale System RFP, Issued May 22, 2020

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UT Medicaid Program Could Save $3.4 Million a Year with Statewide PDL, Audit Finds

The Deseret News reported on May 13, 2020, that the Utah Department of Health could save the state Medicaid program up to $3.4 million per year if it were to adopt a statewide preferred drug list (PDL), according to a new audit report. Utah’s Medicaid program received about $138 million in prescription manufacturer rebates in 2018, but the audit found that the state did not sufficiently verify that all rebates were received. The auditors found that the state could provide more oversight over rebates “to ensure pricing is matching the lowest price index and rebates are billed and received correctly.” Read More

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