In 2017, MACPAC constructed a state-level hospital payment index to compare fee-for-service (FFS) inpatient hospital payments across states and to Medicare payment rates. To update the payment index, we convened a Technical Expert Panel (TEP) with representatives from federal and state government, hospitals, consultants, and researchers. The purpose of the TEP was to discuss ways to leverage current data sources, including newly available data on supplemental and managed care directed payments, to update and expand the prior methodology to include inpatient and outpatient hospital services across FFS and managed care delivery systems. Key themes from the TEP include methods to calculate Medicaid payments using available data sources, meaningful benchmarks for Medicaid payment comparison, methods to account for supplemental payments and provider financing, and uses for the payment index.