The Medicaid and CHIP (Children’s Health Insurance Program) Payment and Access Commission (MACPAC) June 15 released its June Report to Congress. The report focuses on supplemental payments to providers, adult dental coverage, Medicaid’s role in providing health services to at-risk beneficiaries, and psychotropic medications. The commission did not make any recommendations in the report.
The June report explores the use of Delivery System Reform Incentive Payment (DSRIP) programs, a new form of Medicaid supplemental payments. DSRIPs are approved under Section 1115 waiver authority, and can be used by providers to improve delivery of care and quality measurement and promote population health. These incentive payments have been used previously to build electronic health record (EHR) systems, expand primary care clinics, and to develop patient navigator programs, among other activities.
Under the DSRIP programs, incentive payments are tied to the achievement of planning, implementation, reporting, and outcome benchmarks; the intent of these payments is to help shift Medicaid’s role in financing medical care to actually driving improved outcomes. DSRIP programs are currently used in California, New Jersey, Texas, Massachusetts, Kansas and New York. The commission plans to watch closely the development of DSRIPs as they mature and expand into other states.
The report also examines the prevalence of behavioral health conditions among the Medicaid population, which affects almost 9 million Medicaid enrollees and accounted for almost half of all Medicaid spending. The commission examined the various behavioral health conditions, enrollee use of health services, and expenditures of these services in the report, and will continue to focus heavily on identifying policies and interventions to improve care and contain costs for this population.