Proposed Rule Changes to Medicaid Managed Care Payments Could Improve Access and Address Disparities

In April, the Centers for Medicare and Medicaid Services (CMS) released proposed regulations that address states’ authority to direct the amount Medicaid managed care plans pay providers. The final rule will have major implications for the Medicaid program and the more than 70 percent of Medicaid beneficiaries enrolled in managed care.

This blog post addresses how state-directed payments can improve health care access and reduce health disparities, financing challenges associated with state-directed payments, and key considerations as CMS advances final rulemaking on state-directed payments. Future court rulings and CMS’ final rule — expected sometime in 2024 — could have profound consequences for Medicaid financing, payment levels, and provider participation.

To read the full blog post, click here.



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