Last week, on September 23-24, the Medicaid and CHIP Payment and Access Commission (MACPAC) held its first public meeting.  Representatives from the Centers for Medicare & Medicaid Services (CMS), the Medicare Payment Advisory Commission (MedPAC), the Government Accountability Office, state Medicaid offices, and the research community testified about access and payment issues in the Medicaid program and the Children’s Health Insurance Program (CHIP).

Of interest, many of the panelists highlighted the importance of improving coordination for individuals dually eligible for Medicaid and Medicare.  It's been well documented that this population accounts for a disporportionate share of Medicaid and Medicare's spending.  For example, data from MedPAC shows that dual eligible individuals account for 18 percent of all Medicaid enrollees, but almost half of all Medicaid spending.  And on Medicare's side, dual eligible individuals account for 16 percent of all beneficiaries but one quarter of the spending.  Now that Melanie Bella has been annouced as the head of the Federal Coordinated Health Care Office, an office established by the health reform law to improve the integration of Medicare and Medicaid, we are one step closer to jumpstart the process of improving the care of aged, disabled, and economically-disadvantaged Americans.

Another important theme from the meeting was the general lack of data to be able to develop a deeper understanding of Medicaid and CHIP's impact on their enrollees.  Much of this is due to the set up of the Medicaid program, which allows states to customizes the program (within federally set limits) to better serve the needs of their residents.  It is encouraging that CMS is launching new initiatives to improve and consolidate the agency's data collection efforts.  Specifically, Penny Thompson at CMS shared the agency's plans to (1) redesign the Medicaid Statistical Information System to be more operations-friendly and (2) capture performance data from states that show both outcomes within a health system and how states administer their programs.

Similar to MedPAC, MACPAC will be issuing reports twice a year on March 15 and June 15.  I, for one, am looking forward to the work this Commission will undertake to improve access, payment, and quality issues in Medicaid and CHIP.