In the March 2020 Report to Congress on Medicaid and CHIP, MACPAC addresses three issues of interest to Congress: (1) Medicaid disproportionate share hospital (DSH) payments that support the nation’s safety-net hospitals; (2) state reporting on the quality of care provided to the approximately one in five individuals who receive health care coverage through either Medicaid or the State Children’s Health Insurance Program (CHIP); and (3) the timeliness and quality of evaluations of Medicaid demonstrations.
In Chapter 1, MACPAC fulfills its statutorily mandated obligation to submit an annual report on DSH allotments to states. The Commission continues to find little meaningful relationship between DSH allotments and measures of uncompensated care at the state level. In contrast to previous years, however, the Commission reports an increase in the number of uninsured individuals and in the amount of hospital uncompensated care. This increase is occurring at the same time that hospitals face reductions in DSH allotments scheduled for May of 2020.
Chapter 2 examines state readiness to meet, starting in fiscal year (FY) 2024, the mandatory requirement to report on the core set of quality measures for children enrolled in Medicaid and CHIP and the core set of behavioral health measures for adults enrolled in Medicaid.
Chapter 3 discusses state-led evaluations of demonstration programs under Section 1115 of the Social Security Act and their capacity to support decision making. The chapter relies heavily on perspectives shared at a November 2019 MACPAC roundtable of state and federal Medicaid officials, evaluators of state demonstration programs, researchers, and other stakeholders.