This project encompasses Mathematica’s evaluations of Landmark Health’s home-based intensive care model as it was delivered to complex Medicaid and dually eligible beneficiaries in California from 2016-2020. The evaluation assessed the model’s impacts on health care utilization and quality.
- Medicaid data sources
- Program and policy evaluation
- Technical assistance
- Measurement for program monitoring
- Learning collaboratives
- Delivery System Reforms
- Medicaid and CHIP
- State Health Policy
Margaret (Maggie) Samra has more than 15 years of experience in Medicaid, state, and local health policy, and she is an expert in the policy intersections between Medicaid and health insurance marketplaces. Samra has led major technical assistance projects for the Centers for Medicare & Medicaid Services (CMS) and states, including operational support for policy innovations and strategic advising for senior decision makers. She has also directed several multimethod evaluations that combine rigorous quantitative analyses with case studies, examining shifts in enrollment, retention, access, and service utilization caused by changes in provider or beneficiary incentives.
Samra currently directs the Medicaid 1115 demonstration support contract. This contract provides CMS and states with technical assistance on implementing, monitoring, and evaluating several types of Medicaid 1115 demonstrations, including those with policies affecting eligibility, coverage, and financing as well as those addressing substance use disorder, serious mental illness/serious emotional disturbance, value-based care, and social determinants of health.
Previously, Samra directed the national 1115 demonstration evaluation, which examined the cross-state impacts of four types of demonstrations: (1) Delivery System Reform Incentive Payment programs, (2) Managed Long-Term Services and Supports, (3) premium assistance for marketplace plans, and (4) beneficiary engagement and incentives. Under that contract, Samra also helped stand up the first two releases of the Medicaid and CHIP Scorecard, a major initiative to enhance transparency and accountability in these programs. Samra also previously directed the Medicaid and CHIP Learning Collaboratives, which bring together state and federal officials to support the development of integrated and high-performing Medicaid and state marketplace systems that fulfill the requirements of the Affordable Care Act.
At the state level, Samra supported California in developing public reports that present application, eligibility, and enrollment data for both Medi-Cal and Covered California. In that role, she worked directly with state agency decision makers to lead stakeholder engagement to inform the content of the reports, supported the design and data analysis, and developed a training curriculum for state staff to ensure they could maintain the reports.
Samra has served as a task leader and researcher on evaluation studies for the Office of the Assistant Secretary for Planning and Evaluation, the California Health Care Foundation, Medicaid health plans, and state and local governments, including evaluations of Express Lane Eligibility, the Healthy Indiana Plan, California’s Health-e-App Public Access system, Healthy San Francisco, Landmark Health, and the alignment of Medicaid and Medicare enrollment for dual-eligible beneficiaries in Arizona.
Samra, who joined Mathematica in 2007, has published work in Health Services Research, the Maternal and Child Health Journal, Medical Care Research and Review, and the American Journal of Pharmacy Benefits. She holds an M.P.P. from Georgetown University.
Adapting a Model of Integrated and In-Home Care to Serve Medicaid Patients with Multiple Chronic Conditions
New Approaches for Medicaid: The 1115 Demonstration Evaluation
Mathematica's evaluation of Medicaid Section 1115 waiver demonstrations, approximately 40 in number, seeks to assess the implementation and outcomes of four different types of innovations and help CMCS shift toward data-driven decision making for future waiver approvals.
Mathematica to Share Latest Evidence and Insights with Medicaid Experts at National Association of Medicaid Directors Conference
As the U.S. continues to grapple with the COVID-19 pandemic and opioid epidemic, Mathematica experts are working with the Centers for Medicare & Medicaid Services (CMS) and states to help Medicaid and the Children’s Health Insurance Program (CHIP) better address the nation’s pressing health needs.
Helping States Monitor and Evaluate Medicaid 1115 Demonstrations
Mathematica’s health experts recently helped develop new state implementation and monitoring tools, as well as guidance on evaluation methods, for section 1115 Medicaid demonstrations.