The Medicaid and CHIP Payment and Access Commission (MACPAC) hosted its second meeting of the term Oct. 29–30. Presentations and discussion focused on hospital cost drivers and state implementation of community engagement requirements, among other issues.
MACPAC staff presented a literature review of hospital cost drivers, including:
- The relationship between Medicaid payments and hospital costs
- Rural-urban differences
- Managed care and state directed payments
- Hospital closures
- The link between hospital financial conditions and access to services
Commissioners expressed broad interest in how hospital costs, Medicaid payments, and access intersect, particularly how hospital business decisions and financing mechanisms affect access. Discussion focused primarily on rural hospital viability, rural-urban differences, and state directed payments.
MACPAC staff shared how they are monitoring community engagement requirements in four areas: state readiness, medical frailty, beneficiary outreach, and federal and state reporting. A state panel shared implementation activities, including updating systems and conducting beneficiary outreach.
In public comments on hospital cost drivers, America’s Essential Hospitals emphasized the importance of accounting for the costs of essential community services. These include maternity and behavioral health services, which the association characterized as necessary but unprofitable.
MACPAC meets six times a year and submits reports to Congress in March and June. MACPAC’s next meeting of the term is Dec. 10.
Members of the America’s Essential Hospitals Federal Action Network (FAN) can access a full summary of the discussions on our FAN Resource Center. To access these summaries and other policy resources, join the FAN today.
Contact Director of Policy Rob Nelb, MPH, at rnelb@essentialhospitals.org or 202.585.0127 with questions.
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