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MACPAC Releases June Report to Congress

June 22, 2012—The Medicaid and CHIP (Children’s Health Insurance Program) Payment and Access Commission (MACPAC) June 15 released its third report to Congress. The report focuses on Medicaid and CHIP as purchasers of healthcare services and the commission’s ability to achieve value in these two programs, along with an analysis of access to healthcare services for non-elderly adults (ages 19-64).

The commission highlights available data sources for measuring access in both the short and long terms, the various considerations for using these data, and the major issues for assessing access at the state and national levels. The report outlines key principles for developing an effective access monitoring system, including using data sources that reflect multiple care settings, complementing existing efforts to monitor care, and linking access monitoring to quality and health outcomes.

To assess the ability of current non-elderly Medicaid-enrolled adults to access care, the commission conducted an analysis of data from two national household surveys administered annually by the federal government: the Centers for Disease Control and Prevention (CDC) National Health Interview Survey and the Agency for Healthcare Research and Quality (AHRQ) Medical Expenditure Panel Survey.

These surveys provide a broad, national view of how access differs among the uninsured, Medicaid enrollees, and those with private health insurance. After accounting for various socio-economic characteristics, the commission concluded that Medicaid-enrolled adults faired substantially better than those without insurance, but had mixed results compared to adults with employer-sponsored insurance. 

A standard feature of the reports is the inclusion of Medicaid and CHIP statistics.  A few of the relevant statistics on enrollment and spending include:

  • Enrollment among individuals qualifying for Medicaid on the basis of a disability has experienced the largest annual growth rate and accounted for half of real Medicaid spending growth between FY 1975 and FY 2009.

  • Enrollees eligible on the basis of a disability and those who are age 65 and older account for 25 percent of total enrollees but 67 percent of the program’s spending on benefits. Long-term services and supports (LTSS) users account for only about 7 percent of Medicaid enrollees but nearly half of all Medicaid benefit spending across all services.

  • 48 states report using some combination of managed care that involves comprehensive risk-based plans, limited-benefit plans, and primary care case management (PCCM) programs. About 70 percent of Medicaid enrollees are enrolled in one of these arrangements, and nearly half of enrollees are in comprehensive risk-based plans.

The full report, accompanying press release, and fact sheet are available on the MACPAC website. The commission will reconvene in September.


Scott Wetzel, M.P.P.
Lead, Quality Reporting
Telephone: 202-828-0495


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