Project Overview

Objective

Mathematica develops Medicaid 1115 demonstration implementation, 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 operation. We also support CMS is synthesizing data across demonstrations and facilitating learning activities to accelerate promising practices.

Project Motivation

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 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.

Partners in Progress
  • Social Interventions Research and Evaluation Network (SIREN)
  • Health and Reentry Project (HARP)
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 the full range 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, traditional health care practices, and family planning. Under this contract, we create and maintain standardized templates for applications, implementation plans, monitoring metrics and reports, and evaluation design guidance. Many of these products are publicly available on Medicaid.gov. We also synthesize monitoring data as states submit it to CMS, and we have created interactive analytic tools to enable CMS to track demonstration progress, as well as public reports. The project also helped CMS develop and now supports implementation of an updated approach to budget neutrality for 1115 demonstrations, allowing investments in innovation across states with both new and longstanding demonstrations.

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Project Impact

We are proud to be supporting CMS oversight and state innovation across a wide range of policies, including newly approved demonstrations that support transitions back to the community for formerly incarcerated individuals, creative approaches to address HRSNs, and demonstrations addressing substance use disorder and serious mental illness, now approved in more than two-thirds of states. 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, Senior Director, Federal Medicaid Practice

Related Staff

Maggie Samra

Maggie Samra

Senior Director, Federal Medicaid Practice

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Cara Weiss

Cara Weiss

Director, Advisory Services

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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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Jelal Younes

Jelal Younes

Researcher

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Deborah Rosenstein

Deborah Rosenstein

Researcher

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Sydney Garlick

Sydney Garlick

Managing Consultant

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Lauren  Coy

Lauren Coy

Managing Consultant

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Risa Nakajima

Risa Nakajima

Managing Consultant

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