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Coverage and Delivery Reform

Medicaid is a joint federal and state safety net program that assists over 60 million low-income individuals in receiving access to clinician offices, acute and long term care services. Teaching hospitals treat a disproportionate share of Medicaid patients, with approximately 28% of all Medicaid discharges coming from COTH hospitals.

Medicaid also plays a critical role in funding graduate medical education. State and local governments, through their Medicaid programs, appropriate approximately $5 billion for medical school training annually. Most states choose to allocate a portion of their Medicaid budget to fund direct graduate medical education (DGME), indirect medical education (IME), and other special services related to teaching hospitals. Due to state budget shortfalls and the prevalence of Medicaid managed care organizations, there are serious concerns that fewer Medicaid funds will be available to train future physicians.

News and Updates

CMS Announces Medicaid Program Integrity Initiatives

June 29, 2018

The Centers for Medicare and Medicaid Services (CMS) June 26 announced three new initiatives in its efforts to strengthen Medicaid program integrity. Medicaid spending has increased over $100 billion from 2013 to 2016, and the federal share increased by roughly $100 billion, spawning CMS’s reconsideration of its current integrity efforts. CMS notes that it seeks to strengthen integrity through transparency, accountability, and innovative analytics.

Energy and Commerce Committee Holds Mark-Up of Five Public Health Bills

June 29, 2018

The House Energy and Commerce Committee June 27 held a mark-up of five public health bills; the Title VIII Nursing Workforce Reauthorization Act of 2017 (H.R. 959), the Palliative Care and Hospice Education and Training Act (H.R. 1676), the Educating Medical Professionals and Optimizing Workforce Efficiency Readiness Act of 2017 (EMPOWER Act, H.R. 3728); the Children’s Hospital GME Support Reauthorization Act of 2018 (H.R. 5385), and a discussion draft of the Pandemic and All-Hazards Preparedness Reauthorization Act of 2018.

Senate HELP Committee Holds Hearing on the Rising Cost of Health Care

June 29, 2018

The Senate Health, Education, Labor and Pensions (HELP) committee June 27 held a hearing titled “How to Reduce Health Care Costs: Understanding the Cost of Health Care in America.” The hearing is a first in a planned series of hearings to examine health care costs, which will include a hearing on administrative costs, waste, how to improve transparency, and private sector solutions.

MACPAC Delivers June 2018 Report to Congress

June 22, 2018

The Medicaid and CHIP Payment and Access Commission (MACPAC) released its June 2018 Report to Congress, which focuses on the high cost of prescription drugs, the opioid epidemic, and implications for the growing trend of delivering long term services and supports (LTSS) through managed care.

HHS Seeks Public Comment to Develop Workgroup to Increase Innovation and Investment in Healthcare Sector

June 8, 2018

The Department of Health and Human Services (HHS) June 6 released a request for information (RFI) seeking public comment on a planned initiative to develop a workgroup to focus on promoting innovation and investment to provide for significant impact on the health and wellbeing of Americans.  The Department envisions the workgroup as a forum to hear the individual perspectives of attendees and foster new and innovative approaches to tackle the complicated challenges facing the healthcare industry.

On Government Affairs

Testimony and Correspondence

External Resources