Presumptive Eligibility: Creating a Pathway to Ongoing Medi-Cal Coverage

Presumptive eligibility and hospital presumptive eligibility are important tools for states to enroll people with low incomes into temporary Medicaid coverage.

Comprehensive Primary Care Plus (CPC+) Model: Evaluation of the Fourth Year (2020) Findings at a Glance

The Findings at a Glance provides a brief overview of key findings from the independent evaluation of the first four years of CPC+, for practices that began the model in 2017.

Independent Evaluation of the Comprehensive Primary Care Plus (CPC+): Fourth Annual Report

The Fourth Annual Report presents findings from the independent evaluation of the first four years of CPC+ for practices that began the model in 2017. The report examines CPC+ participation, supports, implementation, and impacts.

Conducting Robust Implementation Research for Section 1115 Demonstration Evaluations

This is a guide to best practices in implementation research and practical considerations for using it to evaluate section 1115 Medicaid demonstrations.

Selection of Out-of-State Comparison Groups and the Synthetic Control Method

To support states’ efforts to include comparison groups for section 1115 demonstration evaluations, this white paper describes best practices for identifying suitable comparison states, including suggested selection criteria and data sources.

Section 1115 Alternative Medicaid Expansions: Summative Evaluation Report

This report presents findings from an evaluation of section 1115 demonstrations in six states—Arkansas, Indiana, Iowa, Michigan, Montana, and New Hampshire—that tested new approaches to administering Medicaid for low-income adults during the period 2014 - 2017.

Beneficiary Survey Design and Administration for Eligibility and Coverage Demonstration Evaluations

This guide is an overview of best practices in the design and administration of beneficiary surveys for use in evaluations of section 1115 Medicaid demonstrations.

Planning Section 1115 Demonstration Implementation to Enable Strong Evaluation Designs

This guide describes how states can plan the implementation of their section 1115 Medicaid demonstrations to enable rigorous evaluations.

Effects of a Community-Based Care Management Model for Super Utilizers

The purpose of this study was to test the effectiveness of a high-intensity care management program that the Rutgers University Center for State Health Policy (CSHP) implemented as an adaptation of a promising model developed by the Camden Coalition of Healthcare Providers.

Best Practices in Causal Inference for Evaluations of Section 1115 Eligibility and Coverage Demonstrations

This guide, which uses examples from recent reforms for adult Medicaid beneficiaries, is intended to support demonstration states by describing best practices in causal inference.

Care Coordination for Children with Special Needs in Medicaid: Lessons from Medicare

As increasing numbers of children with special healthcare needs move into Medicaid managed care, health plans can improve care coordination using evidence from Medicare.

Paying for Medicaid Coverage: An Overview of Monthly Payments in Section 1115 Demonstrations

Five states—Arkansas, Indiana, Iowa, Michigan, and Montana—operate section 1115 Medicaid demonstrations that require or encourage monthly payments from Medicaid beneficiaries with incomes up to 133 percent of the federal poverty level.

Wraparound Benefits in Premium Assistance Demonstrations

Arkansas, Iowa, and New Hampshire expanded Medicaid coverage to adults with incomes up to 138 percent of the federal poverty level using section 1115 authority to support beneficiaries’ purchase of coverage from qualified health plans.

Premium Assistance, Monthly Payments, and Beneficiary Engagement Design Plan Supplement: Interim Outcomes Evaluation

This document is a supplement to the Medicaid 1115 Demonstration Evaluation Design Plan prepared by Mathematica Policy Research and submitted to CMS in May 2015.

Beneficiary Understanding of Incentives: Evidence from Interim Demonstration Evaluation Reports in Indiana, Iowa, and Michigan

Indiana, Iowa, and Michigan used section 1115 authority to implement beneficiary engagement programs as part of their Medicaid expansions, seeking to help Medicaid beneficiaries become more active participants in their health care.

Premium Assistance Demonstrations: The Challenges of Interagency and Public/Private Coordination

Three states—Arkansas, Iowa, and New Hampshire—expanded their Medicaid programs using section 1115 demonstration authority to test a new approach to providing premium assistance to people with low incomes.

Beneficiary Engagement Strategies in Medicaid Demonstrations

Four states—Arkansas, Indiana, Iowa, and Michigan—implemented policies that are intended to engage beneficiaries in their health care as part of section 1115 Medicaid demonstrations that expanded coverage.

Promoting Access in Medicaid and CHIP Managed Care: A Toolkit for Ensuring Provider Network Adequacy and Service Availability

In a project for the Centers for Medicare & Medicaid Services Center for Medicaid and CHIP Services, Mathematica developed a toolkit to assist states in developing their network adequacy and service availability standards for Medicaid and CHIP managed care organizations (MCOs).

The Business Case for Community Paramedicine: Lessons from Commonwealth Care Alliance's Pilot Program

This issue brief describes a business case assessment of a community paramedicine pilot program. The program was established to address patients’ non-emergency needs in the home, by expanding the role of emergency medical services personnel to encompass outpatient urgent and primary care.

Evaluation of Health Care Innovation Awards (HCIA): Primary Care Redesign Programs, Second Annual Report, Volume I: Synthesis Report

This report, the second of three planned annual reports, synthesizes findings and draws conclusions from an implementation evaluation; including the clinicians’ experiences with the initiative; and presents preliminary estimates of program impacts by type of target population for 10 PCR programs.

Evaluation of Health Care Innovation Awards (HCIA): Primary Care Redesign Programs, Second Annual Report, Volume II: Individual Program Summaries

Medicaid 1115 Demonstration Evaluation Design Plan

This report lays out the general design and approach Mathematica will use to evaluate four types of Medicaid section 1115 demonstration waivers: (1) Delivery System Reform Incentive Payments (DSRIP), (2) Premium Assistance Medicaid expansions, (3) Beneficiary Engagement/Premium Payment demonstrations,...

PCORI Dissemination and Implementation Toolkit: Appendix Materials

The Patient-Centered Outcomes Research Institute (PCORI) Dissemination and Implementation (D&I) Framework and Toolkit focus on effective approaches to planning and conducting D&I activities.

PCORI Dissemination and Implementation Toolkit

The Dissemination and Implementation (D&I) Toolkit offers illustrative examples of D&I best practices and tactics, as well as resources to help operationalize D&I strategies and planning.

PCORI Dissemination and Implementation Framework

The Dissemination and Implementation (D&I) Framework connects goals for these activities with evidence and best practices, as well as core components of D&I planning and execution.