In response to a request for information (RFI) on advancing equity and support for underserved communities from the Office of Management and Budget, MACPAC highlighted opportunities for the Centers for Medicare & Medicaid Services (CMS) and state agencies that jointly operate Medicaid and the State Children’s Health Insurance Program (CHIP) to both document specific disparities in health care and develop new opportunities to improve access to and the quality of care that beneficiaries receive. This includes prioritizing efforts to improve reporting on race and ethnicity in the Transformed Medicaid Statistical Information System (T-MSIS) and doing more to highlight the importance of these data by disaggregating key measures by race and ethnicity in CMS reports.
The letter also outlines multiple areas that could be addressed through subregulatory guidance, waiver opportunities, and technical assistance. This includes developing more robust approaches to monitoring access, both generally as well as for specific services for which Medicaid plays a predominant role, as well as considering how to improve cultural competency in program operations and policies, including in state Medicaid programs. The letter concludes by calling on CMS to ensure that people of color are not disproportionately affected by activities such as the resumption of regular eligibility redeterminations or the ending of waiver flexibilities when the COVID-19 public health emergency ends.