Margaret (Maggie) Samra has more than 15 years of experience in Medicaid, state, and local health policy. She is an expert in Medicaid 1115 demonstrations as well as 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 and coverage, as well as those addressing substance use disorder, serious mental illness/serious emotional disturbance, value-based care, health-related social needs, and justice-involved populations. The contract also supported CMS in updating its approach to budget neutrality for 1115 demonstrations, allowing investments in innovation across states with both new and longstanding demonstrations.
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.
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.