Medicaid Per Capita Caps Explained
In a new report, the Commonwealth Fund looks at Medicaid per capita caps, an idea that has been discussed for years, that was part of the as-yet unsuccessful American Health Care Act, and a proposal that is almost certain to [...]
New MACPAC Reports
The Medicaid and CHIP Payment and Access Commission has released several new reports, including: a look at how states exercise flexibility in their individual Medicaid programs; methodologies for setting Medicaid per capita caps; a review of how states are addressing [...]
New MACPAC Study Evaluates Medicaid, Medicare Payments
Medicaid payments to hospitals are comparable to or even higher than Medicare payments. Or at least they are once supplemental Medicaid payments are included. So concludes a new study by the Medicaid and CHIP Payment and Access Commission, a non-partisan [...]
Medical Homes and High-Need Patients
With five percent of patients accounting for 50 percent of health care costs, such high-need patients are the subject of increasing attention as health care providers search for better ways to serve them at less cost. Such patients are especially [...]
MedPAC Meets
The Medicare Payment Advisory Committee met last week in Washington, D.C. Among the issues on MedPAC's agenda were: using premium support in Medicare regional variation in Medicare Part A, Part B, and Part D spending and service use measuring low-value [...]
To Require Work or Not to Require Work
That is the question policy-makers are asking as they consider imposing work requirements on healthy Medicaid participants. In recent years a number of states have attempted to establish such a requirement, only to have their requests to do so rejected [...]
CMS Clarifies Medicaid DSH Rule
Last week the Centers for Medicare & Medicaid Services announced a final rule addressing the treatment of third-party payers in calculating Medicaid uncompensated care costs. This calculation affects individual hospitals’ Medicaid disproportionate share (Medicaid DSH) limit. According to CMS, This [...]
Temporarily Gone But Not Forgotten
While last week’s withdrawal of the American Health Care Act at least temporarily halted talk of immediate repeal and replacement of the Affordable Care Act, at least one aspect of that proposed legislation, often discussed in the past, is sure [...]
CMS Shares Evaluation of Medicare-Medicaid Financial Alignment Efforts
In 2011 the Centers for Medicare & Medicaid Services launched a “Medicare-Medicaid Financial Alignment Initiative” that seeks “…to provide Medicare-Medicaid enrollees with a better care experience and to better align the financial incentives of the Medicare and Medicaid programs.” How [...]
MACPAC Looks at Medicaid DSH
Hospitals that serve especially large numbers of Medicaid and low-income patients still need Medicaid disproportionate share hospital payments (Medicaid DSH) to avoid red ink despite the expansion of Medicaid and the increase in the number of uninsured people fostered by [...]
