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 high-cost hepatitis C drugs in their Medicaid programs;
  • an analysis of Medicaid disproportionate share hospital payment (Medicaid DSH) allotments and payments; and
  • an analysis of when states will exhaust their CHIP allotments.

MACPAC is a non-partisan legislative branch agency that advises Congress, the states, and the administration on Medicaid and CHIP payment and access issues.

Find links to these and other MACPAC reports here, on the MACPAC web site.

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 legislative branch agency that advises the states, Congress, and the administration on Medicaid and CHIP payment and access issues.

In what MACPAC bills as the “first-ever study to construct a state-level payment index to compare fee-for-service inpatient hospital payments across states and to benchmark Medicaid payments to other payers such as Medicare,” the study found that

  • Across states, base Medicaid payment for inpatient services varies considerably, ranging from 49 percent to 169 percent of the national average. This variation is similar to the variation across states previously reported for physician fees.
  • States are not consistently high or low payers across all inpatient services due to differences in their payment policies.
  • Payment amounts for the same service can also vary within a state.

The MACPAC analysis also concluded that

  • Overall, Medicaid payment is comparable or higher than Medicare.
  • Specifically, the average Medicaid payment for 18 selected conditions was 6 percent higher than Medicare, and the average Medicaid payment for all but two of the conditions was higher than Medicare.
  • The average Medicaid payment for these 18 services was higher than Medicare in 25 states and lower than Medicare in 22 states.

Learn more about what MACPAC found in its new report “Medicaid Hospital Payment: A Comparison across States and to Medicare,” which can be found here, on MACPAC’s web site.

MACPAC Concerned About Prospect of Medicaid Block Grants

Members of the non-partisan legislative agency that advises Congress on Medicaid and CHIP issues expressed concern at their most recent meeting about the possibility of the federal government turning Medicaid into a block grant program.

At their meeting in Washington, D.C. last week, members of the Medicaid and CHIP Payment and Access Commission discussed the steps they would need to take to advise policy-makers about the issues they would need to address in making such a major policy change and the possibility that such a shift would result in a reduction of funding for Medicaid over time.

These issues are especially important to private safety-net hospitals because of the especially  large numbers of Medicaid patients they serve and the importance of Medicaid revenue to their overall financial health.

Learn more about the MACPAC discussion about Medicaid block grants in this Roll Call article.

MACPAC Points to March Medicaid DSH Report to Congress

Required to report annually to Congress on the state of the Medicaid program, members of the Medicaid and CHIP Payment and Access Commission reviewed drafts of their proposed March report to Congress at the agency’s January meeting in Washington, D.C.

In its draft report MACPAC addresses the Medicaid disproportionate share hospital payment program (Medicaid DSH), including DSH allotments, their relationship to the number of uninsured people, the amount and sources of hospital uncompensated care costs, and the impact of Medicaid DSH on hospitals that provide especially large amounts of uncompensated care while also providing essential community services.

The draft MACPAC report addresses:

  • the decline in the number of uninsured Americans;
  • the Medicaid DSH cuts scheduled to begin in federal FY 2018; and
  • the possibility of changing how Medicaid DSH payments are targeted to DSH-eligible hospitals.

All private safety-net hospitals receive Medicaid DSH payments and those payments are very important to them because they serve so many more uninsured patients than the typical community hospital.

See a draft of the chapter of the MACPAC report on Medicaid DSH here, on the MACPAC web site.

MACPAC Reports to Congress

The Medicaid and CHIP Payment and Access Commission (MACPAC) has released its second of two 2015 reports to Congress on Medicaid and the Children’s Health Insurance Program (CHIP).

In the report, the agency looks at the role of Medicaid in providing behavioral health services; examines Medicaid coverage of dental services for adults; contemplates the intersection between Medicaid and child welfare; and considers whether Delivery System Reform Incentive Payment (DSRIP) programs are a legitimate means of fostering health care delivery reform or have become just a means of states’ supplementing the Medicaid payments they make to providers.

Find a summary of the MACPAC report and a link to the complete report here.