Project Overview

Objective

Mathematica develops Medicaid 1115 demonstration monitoring and evaluation tools to support oversight by the Centers for Medicare & Medicaid Services (CMS) and assist states in building data-driven approaches to demonstration implementation and operation. We are also delivering technical assistance to support implementation of the Money Follows the Person (MFP) demonstrations by helping state grantees build their capacity for data-driven quality improvement.

Project Motivation

In addition to strengthening CMS oversight of Medicaid 1115 demonstrations, the development of new implementation, monitoring, and evaluation tools will help states and the policy community assess the performance of demonstrations. Ultimately, the insights generated by rigorous state-led monitoring and evaluation will contribute to a larger body of knowledge about how to best provide health care to individuals and families through the Medicaid program, which is uniquely positioned to drive improvements in health equity. Similarly, as MFP grantees become better equipped to draw data-driven insights about their programs, they will be able to accelerate quality improvement and elevate best practices.

Partners in Progress
  • Social Interventions Research and Evaluation Network (SIREN)
  • Airam Actuarial Consulting, LLC
  • Technical Assistance Collaborative, Inc.
Prepared For

U.S. Department of Health and Human Services, Centers for Medicare & Medicaid Services, Center for Medicaid and CHIP Services

Mathematica provides technical assistance to CMS and states in implementing, monitoring, and evaluating several types of Medicaid 1115 demonstrations.

Demonstration types include those with policies affecting eligibility and coverage as well as those addressing substance use disorder (SUD), serious mental illness/serious emotional disturbance (SMI/SED), value-based care (VBC), health-related social needs (HRSN), justice-involved populations, and other initiatives that seek to improve health equity. Under this contract, we create and maintain standardized templates for implementation plans, monitoring metrics and reports, and evaluation design guidance. These products are publicly available on Medicaid.gov. We also synthesize monitoring data as states submit it to CMS, and we have built flexible and interactive analytic tools to enable CMS to track demonstration progress. 
The project also supports CMS in updating its approach to budget neutrality for 1115 demonstrations, allowing investments in innovation across states with both new and longstanding demonstrations. Furthermore, we are delivering technical assistance to support MFP demonstrations by building state grantees’ capacity for data-driven quality improvement; our efforts include streamlining reporting requirements and facilitating a learning collaborative to improve data quality, advance quality measurement for home and community-based services (HCBS), and increase public access to MFP program data.

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Project Impact

As of October 2022, we are supporting CMS oversight of 34 demonstrations addressing substance use disorder, 10 demonstrations addressing serious mental illness/serious emotional disturbance, 8 demonstrations focused on HRSN, and 13 demonstrations testing eligibility and coverage policies. Our work to support CMS in updating budget neutrality policies will ultimately enable investments in innovation across states with both new and longstanding demonstrations.

- Maggie Samra, Director of Health Program Improvement, Mathematica

Related Staff

Maggie Samra

Maggie Samra

Senior Director

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Cara Weiss

Cara Weiss

Director, Advisory Services

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Cyrus Jadun

Cyrus Jadun

Managing Consultant

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Michaela Vine

Michaela Vine

Senior Researcher

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Susan Williams

Susan Williams

Senior Researcher

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Kavita Choudhry

Kavita Choudhry

Senior Researcher

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R. Vincent Pohl

R. Vincent Pohl

Senior Researcher

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Ellen Bouchery

Ellen Bouchery

Principal Researcher

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Carol  Irvin

Carol Irvin

Senior Fellow

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Su Liu

Su Liu

Senior Researcher

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