Hospital Physician Directed Payment Arrangement
The Mississippi Division of Medicaid is working on the development of a new directed payment for physician services. This state directed payment arrangement would require a preprint approval by CMS. This program is authorized in Mississippi Code Section 43-13-117(A)(18)(b)(i) which allows DOM to pay additional payments for physician services for physicians who are either employed by or contracted with a hospital.
For any further questions regarding this program, email the QIPP mailbox at QIPP@medicaid.ms.gov.
Managed Care Value-Based Withhold Program
DOM has implemented a Managed Care Value-Based Withhold on MississippiCAN capitation rate payments. This quality withhold is based on established quality metrics, such as Healthcare Effectiveness Data and Information Set (HEDIS) measures, which are already being reported by the CCOs.
DOM has set a 1.0% withhold of capitation rates that began in SFY 2020 and requests approval annually for this program as part of the capitation rate certification performed yearly by CMS. These measures consist of mostly HEDIS measures which are based on prior Calendar Year and other measures including Hospital Readmissions for the respective CCO beneficiaries. For more information regarding the CCOs performance including a list of these performance metrics and results for each CCO for each year, please visit https://medicaid.ms.gov/programs/managed-care/measuring-managed-care-performance/.
Physician Quality Incentive Payment Program (PQIPP)
The PQIPP program development process did not result in a new payment program request to CMS.
Medicaid Presentations
- HFMA 4-2024 Presentation
- HFMA 10-29-2023 Medicaid Presentation
- HFMA 4-2023 Presentation
- HFMA 4-2022 Presentation
- HFMA 6-2021 Presentation
- MSCPA 09-2022 Presentation
Preprints
MHAP
MS MAPS
TREAT
Autism Spectrum Disorder
