Medicaid

MACPAC Meets

Last week the Medicaid and CHIP Payment and Access Commission met in Washington, D.C. The agency performs policy and data analysis and offers recommendations to Congress, the Department of Health and Human Services, and the states. During two days of meetings, MACPAC commissioners received the following presentations: Federal CHIP Funding Update: When Will States Exhaust Their Allotments? Review of June Report Chapter: Program Integrity in Medicaid Managed Care Review of June Report Chapter: Medicaid and the Opioid Epidemic Medicare Savings Program: Eligible But Not Enrolled Medicaid Reform: Implications of Proposed Legislation Preliminary Findings From Evaluations of Medicaid Expansions Under Section [...]

iqtsupport2017-05-04T06:00:23-04:00May 4, 2017|Medicaid|

Health Reform Helps Hospitals in Medicaid Expansion States

The Affordable Care Act’s enhancement of access to health insurance, whether through Medicaid expansion or the subsidization of insurance premiums for working-class and some middle-class Americans, has improved the financial health of hospitals. Especially hospitals in Medicaid expansion states. According to a new report from the Urban Institute, Using data through fiscal year 2015, this new analysis finds that the Medicaid expansion under the ACA increased Medicaid revenue by $5.0 million per hospital, reduced costs of uncompensated care by $3.2 million per hospital, and improved average operating margins by 2.5 percentage points. This study also finds that the financial benefits [...]

iqtsupport2017-04-24T06:00:07-04:00April 24, 2017|Affordable Care Act, hospitals, Medicaid|

Medicaid Work Requirements

Both Congress and a number of states have discussed introducing work requirements into their Medicaid programs. Such a proposal was part of the American Health Care Act, a number of governors and state legislators have discussed work requirements as a condition of Medicaid eligibility, and some states are reportedly considering including such requirements in section 1115 Medicaid waiver applications. In a new report, the Congressional Research Service examines the U.S. Department of Health and Human Services’ authority to grant such waivers and how courts might look at such requirements if they were be contested. Go here to see the Congressional [...]

iqtsupport2017-04-21T06:00:59-04:00April 21, 2017|Medicaid|

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 resurface in the near future. Among other things, the article explains what per capita caps are and how they would work describes how per capita caps differ from current Medicaid policy considers how the implementation of per capita caps might affect low-income people, providers, and insurers Learn more in the Commonwealth Fund article “Essential Facts About Health Reform Alternatives: Medicaid [...]

iqtsupport2017-04-19T06:00:53-04:00April 19, 2017|Medicaid|

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 [...]

iqtsupport2017-04-17T06:00:40-04:00April 17, 2017|MACPAC, Medicaid, Medicare|

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 by regulators in Washington, and a clause permitting states to establish such a requirement was included last month in the eventually sidetracked American Health Care Act. Even now, a Kentucky Medicaid waiver application under consideration by the Centers for Medicare & Medicaid Services includes a work requirement. Does the lack of a work requirement encourage people in Medicaid expansion states [...]

iqtsupport2017-04-03T06:00:50-04:00April 3, 2017|Medicaid|

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 is that initiative working so far? CMS recently released three reports that evaluate different aspects of the program. Those reports are: “Early Findings on Care Coordination in Capitated Medicare-Medicaid Plans under the Financial Alignment Initiative” “Beneficiary Experience: Early Findings from Focus Groups with Enrollees Participating in the Financial Alignment Initiative” “Issue Brief: Special Populations Enrolled in Demonstrations under the Financial [...]

iqtsupport2017-03-29T06:00:30-04:00March 29, 2017|Centers for Medicare & Medicaid Services, Medicaid, Medicare|

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 to arise in the future as well: replacing the current manner in which the federal government matches state Medicaid funding with Medicaid per capita limits or Medicaid block grants. In a new issue brief, the Kaiser Family Foundation examines how a switch to per capita limits or block grants might affect low-income seniors served by both Medicare and Medicaid. Among [...]

iqtsupport2017-03-29T06:00:07-04:00March 29, 2017|Medicaid, Medicare|

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 [...]

iqtsupport2017-03-23T06:00:53-04:00March 23, 2017|Affordable Care Act, hospitals, Medicaid|

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 [...]

iqtsupport2017-03-10T06:00:07-05:00March 10, 2017|Medicaid|