MACPAC issues report to Congress on Medicaid DSH payments: 5 takeaways

The Medicaid and CHIP Payment and Access Commission made a number of recommendations to Congress regarding the Medicaid Disproportionate Share Hospital program in a report released this week.

Here are five takeaways from the MACPAC report.

1. MACPAC said more complete and reliable data on Medicaid payments to hospitals are needed to better analyze current policy and new approaches to target DSH payments. "Greater transparency in how hospitals are being paid is also important to understanding states' use of Medicaid funds and the extent to which these are consistent with federal requirements," according to MACPAC.

2. To address data gaps, the commission recommended that HHS collect and report hospital-specific data on all types of Medicaid payments for all hospitals that receive them.

3. MACPAC recommended HHS collect and report data on the sources of nonfederal share necessary to determine net Medicaid payment at the provider level.

4. The commission said DSH allotments and payments should be better targeted toward states and hospitals that service a disproportionate share of Medicaid and low-income patients and have higher levels of uncompensated care. "The scheduled cuts in DSH allotments make such targeting particularly important," said MACPAC.

5. About half of all U.S. hospitals receive Medicaid DSH payments, but more than one-third of DSH payments are made to hospitals that do not serve a particularly high share of Medicaid and other low-income patients, according to MACPAC.

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Editor's Note: This story was updated on Feb. 3, 2016.



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