Noteworthy News

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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 the Affordable Care Act. So concludes the Medicaid and CHIP Payment and Access Commission (MACPAC) the non-partisan legislative branch agency that advises Congress, the Secretary of the U.S. Department of Health and Human Services, and the states on Medicaid and Children’s Health Insurance Program issues. In its March 2017 report to Congress, MACPAC writes that In both expansion and non-expansion [&hellip

MACPAC Meets, Discusses Medicaid Issues

Members of the non-partisan legislative branch agency that advises Congress, the Secretary of Health and Human Services, and the states on Medicaid and Children’s Health Insurance Program matters met in Washington recently to discuss a number of issues. On the agenda of the Medicaid and CHIP Payment and Access Commission were the following issues: state Medicaid flexibility state Medicaid responses to fiscal pressures a study requested by Congress on mandatory and optional benefits and populations current Medicaid parallels to per capita financing options illustrations of state-level effects of per capita cap design elements high-cost hepatitis C drugs the role of [&hellip

MACPAC Looks at High-Cost Hepatitis C Drugs

The emergence of exceptionally high-cost drugs that offer unprecedented benefits for Hepatitis C patients has posed a considerable challenge to state Medicaid programs:  the drugs offer cures, not treatment, yet their costs are potentially budget-busting. The Medicaid and CHIP Payment and Access Commission commissioned a study to evaluate how these new drugs and their cost have affected state Medicaid programs and the managed care organizations that serve most Medicaid beneficiaries.  Among the issues the study considered were: state coverage and prior authorization policies the impact of the new drugs on state Medicaid budgets and Medicaid managed care organizations how these [&hellip

MACPAC Meets, Discusses Medicaid, CHIP Issues

The non-partisan legislative branch agency that advises Congress, the Secretary of Health and Human Services, and the states on a variety of Medicaid and State Children’s Health Insurance Program issues met last week in Washington, D.C. Among the issues on the agenda of the Medicaid and CHIP Payment and Access Commission were: the flexibility of states in structuring and administering their Medicaid and CHIP programs state Medicaid responses to fiscal pressures studies requested by Congress on mandatory/optional benefits and populations current Medicaid parallels to per capita financing options illustrations of state-level effects of per capita cap design elements high-cost hepatitis [&hellip

Medicaid Directors Look at Value-Based Purchasing

One of the tools many states are using to attempt to reduce their Medicaid costs and improve the quality of the care delivered to their Medicaid beneficiaries is value-based purchasing. In a new issue brief, the National Association of Medicaid Directors takes a closer look at Medicaid value-based purchasing:  what it is, how it works, why it is attractive to state Medicaid programs, what alternative payment models the states are employing as part of their value-based purchasing efforts, and what state Medicaid programs need from the federal government to continue such efforts. Because urban safety-net hospitals care for so many [&hellip

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