Evaluation of Medicaid Demonstrations under New CMS Guidance

Prepared in partnership with the Robert Wood Johnson Foundation

The Centers for Medicare & Medicaid Services (CMS) has formalized and strengthened requirements for evaluation of state Section 1115 Medicaid demonstrations, including new demonstration programs being permitted by the current administration that are both unprecedented and controversial. The increased scientific rigor reflected in this new guidance to states is essential to produce valid and reliable research findings to inform future policymaking in Medicaid.

States are still in the early stages of designing their evaluations to meet the new federal guidance, but many state officials and researchers acknowledge that undertaking these evaluations will have implications for how evaluations are designed, budgeted and implemented.

To provide a resource to help states meet the evaluation standards, Manatt Health partnered with the Robert Wood Johnson Foundation to prepare “Evaluation of Medicaid Demonstrations under New CMS Guidance: State Considerations and Financial Resource Requirements,” a new issue brief identifying the potential implications of the new standards for evaluation design and discussing mechanisms for financing states’ evaluations. The paper systematically analyzes potential new costs to states from the strengthened evaluation standards, methods for developing new evaluation budgets, and options to secure financing from within state budgets or from federal matching funds. This issue brief is the third in a series on 1115 demonstration evaluation and monitoring developed with support from the Robert Wood Johnson Foundation.

Click here to access the full issue brief.

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