In 2016, the Centers for Medicare & Medicaid Services authorized states to direct Medicaid managed care organizations to pay providers according to specific rates or methods.  Typically, states use these arrangements, often referred to as state directed payments, to establish minimum payments for certain types of providers or to require participation in value-based payment arrangements.  A few states, though, use state directed payments to require Medicaid managed care organizations to make large, additional payments to providers similar to supplemental payments their Medicaid fee-for-service programs.

In a new issue brief, the Medicaid and CHIP Payment and Access Commission describes the history of Medicaid state directed payment policy and examines the use of these payments by the states.  Learn more from the MACPAC report “Directed Payments in Medicaid Managed Care.”