MACPAC September Meeting Features Inpatient Hospital Payment Analysis

The Medicaid and CHIP Payment and Access Commission (MACPAC) hosted its first meeting of the term Sept. 24-25. Commissioners met to hear public presentations and lead public discussion about key Medicaid issues, including:

• The community engagement requirements interim final rule and monitoring framework
• State directed payment (SDP) and provider tax proposed rules
• The inpatient hospital payment index

MACPAC staff presented a comparison of Medicaid inpatient hospital payment levels across states and relative to the national average, updating an analysis from 2017. The current analysis uses data from 2022 and did not include changes from the proposed new Medicaid rules. The analysis does include both gross and net payments. MACPAC is in the process of comparing Medicaid inpatient hospital payment to Medicare payment rates. This analysis will be in a future report to Congress.

MACPAC staff discussed their monitoring framework for community engagement requirement implementation. An expert panel shared with commissioners that new Centers for Medicare & Medicaid Services resources were helpful to states and identified areas where states need further guidance.

Commissioners also heard summaries of SDP and provider tax proposed rules; MACPAC will conduct future analysis on their impact.

The association provided public comments on the SDP rule, noting the proposed policy extends beyond the intent and scope of the underlying statute and could have a broader impact than Congress anticipated.

MACPAC meets six times a year and submits reports to Congress in March and June. MACPAC's next meeting of the term is Oct. 29.

Members of the America's Essential Hospitals Federal Action Network (FAN) can access a full summary of both discussions on our FAN Resource Center. To access these summaries and other policy resources, join the FAN today.