Projects

Supporting CMS Oversight of Medicaid 1115 Demonstrations

2019-2024

Project Overview

Objective

Mathematica is developing Medicaid 1115 demonstration implementation and monitoring tools to support oversight by the Centers for Medicare & Medicaid Services (CMS). 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. In addition, we are helping states address the opioid epidemic with a combination of strategies inside and outside of 1115 demonstrations—including those related to housing supports and care coordination services under Medicaid.

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 the 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 vulnerable individuals and families through the Medicaid program. 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 and those addressing substance use disorder (SUD), serious mental illness/serious emotional disturbance (SMI/SED), value-based care (VBC), and social determinants of health (SDOH). 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. The project also supports CMS in considering budget-neutrality models and in developing and implementing a technical assistance program to help states deliver housing-related supports to Medicaid beneficiaries with SUD. 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 November 2021, we are supporting CMS oversight of 32 demonstrations addressing substance use disorder, 7 demonstrations addressing serious mental illness/serious emotional disturbance, and 10 demonstrations testing eligibility and coverage policies.

- Maggie Samra, Director of Health Program Improvement

Related Staff

Maggie Samra

Maggie Samra

Senior Director

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Cara Weiss

Cara Weiss

Principal, Program Advisor

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Katharine Bradley

Katharine Bradley

Senior Researcher

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Kavita Choudhry

Kavita Choudhry

Senior Researcher

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Brigitte Manteuffel

Brigitte Manteuffel

Senior Fellow

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