At its monthly meeting on Thursday, the Medicaid and CHIP Payment and Access Commission continued its discussion of whether federal policies can—or should—help states collaborate to bolster their administrative capacity.
The Commission heard from Rhonda Anderson, director of the Drug Review Effectiveness Project at Oregon Health and Science University, and Elena Nicollela, executive director of the New England States Consortium Systems Organization. Both organizations bring leaders and experts from multiple states together to solve organizational and financial challenges in healthcare.
This session was part of an ongoing discussion. The Commission’s June 2014 report identified multistate partnerships as one way to improve states’ administrative capacity. Last fall, it discussed the idea that “federal policies encourage, incentivize, and fund state collaboration.”
Commissioners discussed why the federal government should incentivize collaboration (if it should), what it could do to promote collaboration, and what issues it would encourage the groups to solve.
Kit Gorton, M.D., suggested collaborations could produce cost savings, since many Medicaid programs are trying to solve the similar problems.
At one point, six states were spending "an administrative fortune" on a population that would have fit inside Pennsylvania alone, Gorton said.
Alan Weil agreed: “These are not policy consortia, these are practical operational consortia. In a world where there are 55 separate policymakers around Medicaid policy, opportunities for alignment are hard to find,” he said.
States would especially want to learn from other states about best practices, said Toby Douglas, though Stacey Lampkin later pointed out that it may be helpful to understand what information states can access already.
However, the federal government can’t force states can’t to collaborate with one another; the states must believe they will benefit, said Darin Gordon. Plus, effective multistate collaborations already exist, like the National Governors Association’s Center for Best Practices, said Chuck Gordon, J.D.
There may be opportunities to bring together states heading in the same direction, said Penny Thompson, MACPAC’s chair.
Thompson asked presenter Moira Forbes to provide the Commission with collaboration models that have been tried, as well as potential ways to incentivize states to work together.