As the debate over the repeal of the Affordable Care Act (ACA) continues, the federal Health and Human Services (HHS) and Center for Medicare and Medicaid Services (CMS) are encouraging states to apply for Section 1115 Medicaid demonstration waivers to change eligibility, enrollment, and benefits beyond what is permitted under current guidelines.
CHCF will maintain this list of resources and analyses about Medicaid waiver activity across the country and its likely impacts with a particular focus on waivers that seek to change eligibility, enrollment, or benefits through features such as work requirements, health savings accounts, healthy behavior incentives, requiring enrollees to pay a portion of premiums, and/or other out-of-pocket costs, and more. This will include waivers that have not been approved by the Centers for Medicare & Medicaid Services (CMS) to date, as well as several that were approved by the Obama administration as part of negotiations with select states to expand Medicaid under the ACA. Resources are organized reverse-chronologically and under the following headings:
- Background on how waivers work and why they are in the spotlight now
- Syntheses and summaries of waiver activity across multiple states
- Analyses or evaluations of implemented waivers
This page will be updated regularly. If you have suggested additions, please email Anne Sunderland.
BACKGROUND
States will be allowed to impose Medicaid work requirements, top federal official says
Provides highlights of a November 7, 2017 speech by CMS Administrator Seema Verma to the National Association of Medicaid Directors. The speech was "Verma's most detailed public explanation of how she plans to approach Medicaid in a[n]... era in which Republicans still hope to roll back its expansion." (Washington Post, November 8, 2017)
Provides highlights of a November 7, 2017 speech by CMS Administrator Seema Verma to the National Association of Medicaid Directors. The speech was "Verma's most detailed public explanation of how she plans to approach Medicaid in a[n]... era in which Republicans still hope to roll back its expansion." (Washington Post, November 8, 2017)
Personal Responsibility in Medicaid
In this presentation to the annual Health Management Associates conference, CHCF Improving Access director, Chris Perrone, summarizes the research to date around the impact of features such as premium and cost-sharing, healthy behaviors incentives, and work requirements on Medicaid and low-income consumers. The presentation also provides useful context around the unique health needs and utilization patterns of Medicaid enrollees, the financial pressures within Medicaid, and approaches being pursued in California to control costs and improve care within the state's Medi-Cal program. (Chris Perrone, California Health Care Foundation, September 12, 2017)
In this presentation to the annual Health Management Associates conference, CHCF Improving Access director, Chris Perrone, summarizes the research to date around the impact of features such as premium and cost-sharing, healthy behaviors incentives, and work requirements on Medicaid and low-income consumers. The presentation also provides useful context around the unique health needs and utilization patterns of Medicaid enrollees, the financial pressures within Medicaid, and approaches being pursued in California to control costs and improve care within the state's Medi-Cal program. (Chris Perrone, California Health Care Foundation, September 12, 2017)
Letter to Governors from HHS Secretary Thomas Price and CMS Administrator Seema Verma (PDF)
Outlines HHS and CMS' approach to Medicaid waivers under the Trump administration. Encourages demonstrations in specific areas, including job training and employment and "align[ing] Medicaid and private insurance policies for non-disabled adults." (Department of Health and Human Services, March 2017)
Outlines HHS and CMS' approach to Medicaid waivers under the Trump administration. Encourages demonstrations in specific areas, including job training and employment and "align[ing] Medicaid and private insurance policies for non-disabled adults." (Department of Health and Human Services, March 2017)
Section 1115 Waivers: An Introduction
A webcast featuring Joan Alker, executive director of the Center for Children and Families of the Georgetown University Health Policy Institute, that describes how Medicaid 1115 waivers work, what they can and cannot do, and when they may not be needed, in addition to providing information on application and public comment processes, evaluation, and budget neutrality requirements. (Joan Alker, Georgetown University Health Policy Institute, February 23, 2017)
A webcast featuring Joan Alker, executive director of the Center for Children and Families of the Georgetown University Health Policy Institute, that describes how Medicaid 1115 waivers work, what they can and cannot do, and when they may not be needed, in addition to providing information on application and public comment processes, evaluation, and budget neutrality requirements. (Joan Alker, Georgetown University Health Policy Institute, February 23, 2017)
SYNTHESES
Medicaid Retroactive Coverage Waivers: Implications for Beneficiaries, Providers, and States
Highlights CMS's October 2017 approval of Iowa's Section 1115 waiver request permitting the elimination of three-month retroactive coverage for nearly all new Medicaid applicants. Iowa's waiver is expected to reduce monthly enrollment by 3,344 enrollees and reduce annual federal and state Medicaid spending by $36.8 million ($9.7 million state share). Notes that relatively little is yet known about the impact of such waivers on patients' access to care, and that it is unclear whether or not Iowa will conduct an evaluation of this new policy. (Kaiser Family Foundation, November 10, 2017)
Highlights CMS's October 2017 approval of Iowa's Section 1115 waiver request permitting the elimination of three-month retroactive coverage for nearly all new Medicaid applicants. Iowa's waiver is expected to reduce monthly enrollment by 3,344 enrollees and reduce annual federal and state Medicaid spending by $36.8 million ($9.7 million state share). Notes that relatively little is yet known about the impact of such waivers on patients' access to care, and that it is unclear whether or not Iowa will conduct an evaluation of this new policy. (Kaiser Family Foundation, November 10, 2017)
What to Watch for in Trump Administration Actions on Medicaid Waivers
Catalogs pending state Medicaid waiver proposals that base Medicaid eligibility on work-related activities or drug screening; impose premiums on people with incomes below the poverty line; impose a time limit on Medicaid enrollment; limit the Medicaid expansion to people with incomes below the poverty line; and lock people out of coverage for failure to report certain information in a timely manner. Highlights Kentucky’s pending waiver request — which will likely be the first to be acted upon by the Trump administration — as a "bellwether" of what may be approved in other states. The Kentucky proposal includes work requirements, higher premiums, and a lock-out, and is predicted to reduce the number of Medicaid enrollees. (Center on Budget and Policy Priorities, November 2, 2017)
Catalogs pending state Medicaid waiver proposals that base Medicaid eligibility on work-related activities or drug screening; impose premiums on people with incomes below the poverty line; impose a time limit on Medicaid enrollment; limit the Medicaid expansion to people with incomes below the poverty line; and lock people out of coverage for failure to report certain information in a timely manner. Highlights Kentucky’s pending waiver request — which will likely be the first to be acted upon by the Trump administration — as a "bellwether" of what may be approved in other states. The Kentucky proposal includes work requirements, higher premiums, and a lock-out, and is predicted to reduce the number of Medicaid enrollees. (Center on Budget and Policy Priorities, November 2, 2017)
Section 1115 Demonstrations
Resource page that includes an overview of Section 1115 waivers, the application process, transparency requirements, CMS-sponsored evaluations, and a searchable database of all current and concluded state programs authorized under Section 1115 and 1915 waivers. (Centers for Medicare & Medicaid Services)
Resource page that includes an overview of Section 1115 waivers, the application process, transparency requirements, CMS-sponsored evaluations, and a searchable database of all current and concluded state programs authorized under Section 1115 and 1915 waivers. (Centers for Medicare & Medicaid Services)
Section 1115 Medicaid Demonstration Waivers: A Look at the Current Landscape of Approved and Pending Waivers
Issue brief with an appendix that lists all approved and pending Section 1115 waivers. As of September 2017, 33 states have 41 approved waivers and 18 states have 21 pending waivers. Seven states (Arizona, Arkansas, Indiana, Iowa, Michigan, Montana, and New Hampshire) used Section 1115 waivers to implement the ACA Medicaid expansion; these waivers also include restrictions on benefits and cost sharing. Emerging themes among the 21 pending waivers include work requirements and more restrictive eligibility and enrollment provisions than have been approved to date. In many cases, requirements in pending waivers would apply to both traditional and expansion Medicaid populations. (Elizabeth Hinton et al., Kaiser Family Foundation, September 13, 2017)
Issue brief with an appendix that lists all approved and pending Section 1115 waivers. As of September 2017, 33 states have 41 approved waivers and 18 states have 21 pending waivers. Seven states (Arizona, Arkansas, Indiana, Iowa, Michigan, Montana, and New Hampshire) used Section 1115 waivers to implement the ACA Medicaid expansion; these waivers also include restrictions on benefits and cost sharing. Emerging themes among the 21 pending waivers include work requirements and more restrictive eligibility and enrollment provisions than have been approved to date. In many cases, requirements in pending waivers would apply to both traditional and expansion Medicaid populations. (Elizabeth Hinton et al., Kaiser Family Foundation, September 13, 2017)
Section 1115 Medicaid Expansion Waivers: A Look at Key Themes and State Specific Waiver Provisions
Issue brief focusing on approved and pending Section 1115 waivers that implement the ACA's Medicaid expansion. (These are a subset of all approved and pending Section 1115 waivers, which are described in a companion paper above.) Focuses on work requirements and more restrictive eligibility and enrollment provisions than have been approved to date. An appendix provides extensive details about approved and pending Medicaid expansion waivers in each relevant state. (MaryBeth Musumeci, Elizabeth Hinton, and Robin Rudowitz, Kaiser Family Foundation, August 16, 2017)
Issue brief focusing on approved and pending Section 1115 waivers that implement the ACA's Medicaid expansion. (These are a subset of all approved and pending Section 1115 waivers, which are described in a companion paper above.) Focuses on work requirements and more restrictive eligibility and enrollment provisions than have been approved to date. An appendix provides extensive details about approved and pending Medicaid expansion waivers in each relevant state. (MaryBeth Musumeci, Elizabeth Hinton, and Robin Rudowitz, Kaiser Family Foundation, August 16, 2017)
State-Specific Medicaid Program Changes
As of June 2017, a compendium of key pending waiver requests for both ACA Medicaid expansion and traditional Medicaid populations. Organized by waiver feature and state. (Anita Cardwell, National Academy for State Health Policy, June 13, 2017).
As of June 2017, a compendium of key pending waiver requests for both ACA Medicaid expansion and traditional Medicaid populations. Organized by waiver feature and state. (Anita Cardwell, National Academy for State Health Policy, June 13, 2017).
Emerging Themes in Proposed State Medicaid Waivers
High-level overview of waiver features in the seven states (Arizona, Arkansas, Indiana, Iowa, Michigan, Montana, and New Hampshire) that used Section 1115 to expand Medicaid. The paper also highlights pending waivers in other states that incorporate disenrollment for nonpayment of premiums, work requirements as a condition of eligibility, time limits on coverage, and drug screening. Notes that "states considering similar proposals for Medicaid enrollees will need to take into account the potential for increased administrative costs and staff burdens associated with tracking individuals' compliance to various requirements, determining which populations are exempt, and providing clear information to beneficiaries about complex program rules." (Anita Cardwell, National Academy for State Health Policy, June 13, 2017)
High-level overview of waiver features in the seven states (Arizona, Arkansas, Indiana, Iowa, Michigan, Montana, and New Hampshire) that used Section 1115 to expand Medicaid. The paper also highlights pending waivers in other states that incorporate disenrollment for nonpayment of premiums, work requirements as a condition of eligibility, time limits on coverage, and drug screening. Notes that "states considering similar proposals for Medicaid enrollees will need to take into account the potential for increased administrative costs and staff burdens associated with tracking individuals' compliance to various requirements, determining which populations are exempt, and providing clear information to beneficiaries about complex program rules." (Anita Cardwell, National Academy for State Health Policy, June 13, 2017)
PRIMER: A Survey of State Medicaid Expansion 1115 Waivers
A description of Section 1115 waivers for the expansion of Medicaid under the ACA in seven approved states (Arizona, Arkansas, Indiana, Iowa, Michigan, Montana, and New Hampshire) and one pending approval (Kentucky). The primer also includes a description of Wisconsin's state-funded Medicaid expansion. It presents evaluation data where available. (Tara O'Neill Hayes, American Action Forum, May 22, 2017)
A description of Section 1115 waivers for the expansion of Medicaid under the ACA in seven approved states (Arizona, Arkansas, Indiana, Iowa, Michigan, Montana, and New Hampshire) and one pending approval (Kentucky). The primer also includes a description of Wisconsin's state-funded Medicaid expansion. It presents evaluation data where available. (Tara O'Neill Hayes, American Action Forum, May 22, 2017)
Overview of Alternative Medicaid Expansion Waivers (PDF)
Overview, as of January 2017, of both approved and rejected features of "alternative Medicaid expansion" waivers in seven states, including Indiana, whose waiver was crafted under the leadership of current CMS Administrator Seema Verna. Waiver features include premiums, cost sharing, health savings accounts, healthy behavior incentives, work requirements, benefits and eligibility variations, and premium assistance through state exchanges and/or employer-based insurance. (Patricia Boozang, Deborah Bachrach, and Mindy Lipson, State Health Reform Assistance Network, January 2017)
Overview, as of January 2017, of both approved and rejected features of "alternative Medicaid expansion" waivers in seven states, including Indiana, whose waiver was crafted under the leadership of current CMS Administrator Seema Verna. Waiver features include premiums, cost sharing, health savings accounts, healthy behavior incentives, work requirements, benefits and eligibility variations, and premium assistance through state exchanges and/or employer-based insurance. (Patricia Boozang, Deborah Bachrach, and Mindy Lipson, State Health Reform Assistance Network, January 2017)
ANALYSES AND EVALUATIONS
The Effects of Premiums and Cost Sharing on Low-Income Populations: Updated Review of Research Findings
Analysis of 65 papers published between the years 2000 and 2017 on the effects of premiums and cost sharing on low-income populations in Medicaid and CHIP. It finds that premiums are a barrier to obtaining and maintaining Medicaid and CHIP coverage among low-income individuals, with the largest effects among the lowest-income individuals, and that even relatively small levels of cost sharing ($1 to $5) are associated with reduced use of care, including necessary services. Further, it finds that cost sharing can also result in increased use of the emergency room and have a negative effect on access to care and health outcomes. It notes that state savings from premiums and cost sharing in Medicaid and CHIP are limited and are offset by increased disenrollment, increased use of more expensive services, increased costs in other areas, and administrative expenses. (Kaiser Family Foundation, June 1, 2017)
Analysis of 65 papers published between the years 2000 and 2017 on the effects of premiums and cost sharing on low-income populations in Medicaid and CHIP. It finds that premiums are a barrier to obtaining and maintaining Medicaid and CHIP coverage among low-income individuals, with the largest effects among the lowest-income individuals, and that even relatively small levels of cost sharing ($1 to $5) are associated with reduced use of care, including necessary services. Further, it finds that cost sharing can also result in increased use of the emergency room and have a negative effect on access to care and health outcomes. It notes that state savings from premiums and cost sharing in Medicaid and CHIP are limited and are offset by increased disenrollment, increased use of more expensive services, increased costs in other areas, and administrative expenses. (Kaiser Family Foundation, June 1, 2017)
Medicaid Lessons from Pioneering States
A collection of resources synthesizing available evidence on how Medicaid HSAs, cost sharing, payment enforcement, and healthy behavior programs have worked in Arkansas, Indiana, and Michigan — all states that used Section 1115 waivers to expand Medicaid under the ACA. Includes:
A collection of resources synthesizing available evidence on how Medicaid HSAs, cost sharing, payment enforcement, and healthy behavior programs have worked in Arkansas, Indiana, and Michigan — all states that used Section 1115 waivers to expand Medicaid under the ACA. Includes:
- HSAs, Cost Sharing, Payment Enforcement, and Healthy Behavior Programs in Medicaid, a recorded webinar overview of the complete set of resources
- Developing and Implementing Health Savings Accounts in Medicaid: Lessons from Pioneering States (PDF)
- Cost Sharing, Payment Enforcement, and Healthy Behavior Programs in Medicaid: Lessons from Pioneering States (PDF)
- Health Savings Accounts in Medicaid (PDF)
- Cost Sharing in Medicaid (PDF)
- Payment Enforcement in Medicaid (PDF)
- Healthy Behavior Programs in Medicaid (PDF)
(Vanderbilt University School of Medicine, June 2017)
Healthy Michigan Quarterly Report for Second Quarter of Federal Fiscal Year 2017 (PDF)
This paper describes Healthy Michigan, the 1115 waiver program through which the state expanded Medicaid under the ACA in 2014, with all enrollees either choosing or being assigned to a Medicaid managed care plan. The program is intended to "test innovative approaches to beneficiary cost sharing and financial responsibility for health care for the new adult eligibility group." Provides data on enrollment, choice of plans, number of beneficiaries completing a health risk assessment and engaging in certain documented healthy activities (actions that result in reduced cost sharing), status of outreach and enrollment efforts, status of encounter data collection, consumer complaints, quality monitoring activities, etc. (Michigan Department of Health and Human Services, June 19, 2017)
This paper describes Healthy Michigan, the 1115 waiver program through which the state expanded Medicaid under the ACA in 2014, with all enrollees either choosing or being assigned to a Medicaid managed care plan. The program is intended to "test innovative approaches to beneficiary cost sharing and financial responsibility for health care for the new adult eligibility group." Provides data on enrollment, choice of plans, number of beneficiaries completing a health risk assessment and engaging in certain documented healthy activities (actions that result in reduced cost sharing), status of outreach and enrollment efforts, status of encounter data collection, consumer complaints, quality monitoring activities, etc. (Michigan Department of Health and Human Services, June 19, 2017)
How Many Will Be Impacted by Work Requirements: Indiana Gives Us the First Clue
Highlights data from Indiana's pending Section 1115 waiver amendment (PDF) and accompanying analysis by the state's independent evaluator, Milliman. The author calculates that, if proposed work requirements were applied to current beneficiaries, just under 25,000 would lose coverage for noncompliance, out of a total of 438,000 people enrolled in Healthy Indiana 2.0. (Joan Alker and Alexandra Corcoran, Georgetown University Health Policy Institute, May 26, 2017)
Highlights data from Indiana's pending Section 1115 waiver amendment (PDF) and accompanying analysis by the state's independent evaluator, Milliman. The author calculates that, if proposed work requirements were applied to current beneficiaries, just under 25,000 would lose coverage for noncompliance, out of a total of 438,000 people enrolled in Healthy Indiana 2.0. (Joan Alker and Alexandra Corcoran, Georgetown University Health Policy Institute, May 26, 2017)
Preliminary Findings from Evaluations of Medicaid Expansions Under Section 1115 Waivers (PDF)
This presentation before the Medicaid and CHIP Payment and Access Commission (MACPAC) in April 2017 provides background on Section 1115 waivers in addition to the features of Medicaid expansion waivers in seven states and across four design elements (benefits waived, premiums and cost sharing, healthy behavior incentives, and premium assistance). Early evaluation findings from Arkansas, Indiana, Iowa, and Michigan include evidence that changes in cost sharing have not significantly altered beneficiary behavior, beneficiary understanding of health savings account programs is mixed, and the use of preventive services is high, but substantial portions of members do not understand or are unaware of healthy behavior incentive structures. It also presents limited findings on premium assistance. (Kacey Buderi, MACPAC, April 20, 2017)
This presentation before the Medicaid and CHIP Payment and Access Commission (MACPAC) in April 2017 provides background on Section 1115 waivers in addition to the features of Medicaid expansion waivers in seven states and across four design elements (benefits waived, premiums and cost sharing, healthy behavior incentives, and premium assistance). Early evaluation findings from Arkansas, Indiana, Iowa, and Michigan include evidence that changes in cost sharing have not significantly altered beneficiary behavior, beneficiary understanding of health savings account programs is mixed, and the use of preventive services is high, but substantial portions of members do not understand or are unaware of healthy behavior incentive structures. It also presents limited findings on premium assistance. (Kacey Buderi, MACPAC, April 20, 2017)
Evidence from the Private Option: The Arkansas Experience
Evaluation of the first two years of Arkansas's Section 1115 waiver expanding Medicaid under the ACA. The waiver approach, "known as the 'private option,' uses Medicaid funds to purchase private health plans on the state's marketplace." It finds that "Arkansas's private option improved access to primary care and prescription medications, reduced reliance on the emergency department, increased use of preventive care, and improved perceptions of quality and health among low-income adults in the state compared to Texas, which did not expand Medicaid. Arkansas's benefits were similar to those observed in Kentucky's traditional Medicaid expansion." (Bethany Maylone and Benjamin D. Sommers, The Commonwealth Fund, February 22, 2017)
Evaluation of the first two years of Arkansas's Section 1115 waiver expanding Medicaid under the ACA. The waiver approach, "known as the 'private option,' uses Medicaid funds to purchase private health plans on the state's marketplace." It finds that "Arkansas's private option improved access to primary care and prescription medications, reduced reliance on the emergency department, increased use of preventive care, and improved perceptions of quality and health among low-income adults in the state compared to Texas, which did not expand Medicaid. Arkansas's benefits were similar to those observed in Kentucky's traditional Medicaid expansion." (Bethany Maylone and Benjamin D. Sommers, The Commonwealth Fund, February 22, 2017)
An Early Look at Medicaid Expansion Waiver Implementation in Michigan and Indiana
Describes Indiana and Michigan's approved Section 1115 Medicaid expansion waivers, focusing on premiums, health savings accounts, and healthy behavior incentive programs. The paper presents insights based on "22 in-person and telephone interviews conducted in July and August 2016 with state officials, providers, health plans, beneficiary advocates, and enrollment assistors" in both states, in addition to reports from the state Medicaid agencies and four beneficiary focus groups. Key insights include evidence that, among other things, implementation of complex programs involves collaboration with many stakeholders, sophisticated IT systems, and administrative costs; premium costs and complex enrollment policies can deter eligible people from enrolling in coverage; and health savings accounts can be confusing for beneficiaries. (MaryBeth Musumeci et al., Kaiser Family Foundation, January 31, 2017)
Describes Indiana and Michigan's approved Section 1115 Medicaid expansion waivers, focusing on premiums, health savings accounts, and healthy behavior incentive programs. The paper presents insights based on "22 in-person and telephone interviews conducted in July and August 2016 with state officials, providers, health plans, beneficiary advocates, and enrollment assistors" in both states, in addition to reports from the state Medicaid agencies and four beneficiary focus groups. Key insights include evidence that, among other things, implementation of complex programs involves collaboration with many stakeholders, sophisticated IT systems, and administrative costs; premium costs and complex enrollment policies can deter eligible people from enrolling in coverage; and health savings accounts can be confusing for beneficiaries. (MaryBeth Musumeci et al., Kaiser Family Foundation, January 31, 2017)
Indiana Healthy Indiana Plan 2.0: Interim Evaluation Report (PDF)
This report, as required by CMS, provides an independent evaluation of the progress made by the Healthy Indiana Plan (HIP) 2.0 in the first year of a three-year demonstration period (February 1, 2015, to January 31, 2018). The report describes the features of HIP 2.0, including coverage through a high-deductible health plan paired with a Personal Wellness and Responsibility (POWER) account, with richer coverage available to those who make contributions to POWER accounts, and thinner coverage available to those who do not. Members with incomes above 100% FPL who do not make contributions are disenrolled from HIP 2.0 and locked out for six months. Also described are the HIP Link premium assistance program for employer-based insurance and Gateway to Work (GTW), a voluntary job training and search program for eligible HIP members. (The Lewin Group, July 6, 2016)
This report, as required by CMS, provides an independent evaluation of the progress made by the Healthy Indiana Plan (HIP) 2.0 in the first year of a three-year demonstration period (February 1, 2015, to January 31, 2018). The report describes the features of HIP 2.0, including coverage through a high-deductible health plan paired with a Personal Wellness and Responsibility (POWER) account, with richer coverage available to those who make contributions to POWER accounts, and thinner coverage available to those who do not. Members with incomes above 100% FPL who do not make contributions are disenrolled from HIP 2.0 and locked out for six months. Also described are the HIP Link premium assistance program for employer-based insurance and Gateway to Work (GTW), a voluntary job training and search program for eligible HIP members. (The Lewin Group, July 6, 2016)
Arkansas Health Care Independence Program ("Private Option") Section 1115 Demonstration Waiver Interim Evaluation Report
As required by CMS, Arkansas provided an interim evaluation of its Health Care Independence Program (HCIP), an ACA Medicaid expansion established by Section 1115 waiver. The program, also known as the "private option," uses premium assistance to secure private health insurance through the state's exchange for nonelderly adults with incomes at or below 138% FPL. The program covered 225,000 people through 2015. The report examines claims, enrollment, provider, and survey data from 2014. Compared to traditional Medicaid, HCIP enrollees had improved access, improved used of preventive care, reduced use of emergency department care, and higher per-member, per-month costs. (Arkansas Center for Health Improvement, June 16, 2016)
As required by CMS, Arkansas provided an interim evaluation of its Health Care Independence Program (HCIP), an ACA Medicaid expansion established by Section 1115 waiver. The program, also known as the "private option," uses premium assistance to secure private health insurance through the state's exchange for nonelderly adults with incomes at or below 138% FPL. The program covered 225,000 people through 2015. The report examines claims, enrollment, provider, and survey data from 2014. Compared to traditional Medicaid, HCIP enrollees had improved access, improved used of preventive care, reduced use of emergency department care, and higher per-member, per-month costs. (Arkansas Center for Health Improvement, June 16, 2016)
Section 1115 Demonstration Extension — Iowa Wellness Plan (PDF)
June 2016 proposal to HHS to extend the Iowa Wellness Plan. The plan includes the state's own evaluation of the original waiver, approved in 2014 under the name "Iowa Health and Wellness Plan" (IHAWP). The evaluation was conducted in December 2015 by the University of Iowa Public Policy Center and found that "enrollees have experienced enhanced access to care and positive outcomes on a variety of quality measures. Of note, when compared to low-income Medicaid State Plan enrollees, waiver recipients have lower emergency department and prescription drug per-member, per-month costs, higher rates of preventive care, and lower unmet need for nonemergency medical transportation." Evaluations findings begin on page 14 of the extension request. (Iowa Department of Health and Human Services, June 1, 2016)
June 2016 proposal to HHS to extend the Iowa Wellness Plan. The plan includes the state's own evaluation of the original waiver, approved in 2014 under the name "Iowa Health and Wellness Plan" (IHAWP). The evaluation was conducted in December 2015 by the University of Iowa Public Policy Center and found that "enrollees have experienced enhanced access to care and positive outcomes on a variety of quality measures. Of note, when compared to low-income Medicaid State Plan enrollees, waiver recipients have lower emergency department and prescription drug per-member, per-month costs, higher rates of preventive care, and lower unmet need for nonemergency medical transportation." Evaluations findings begin on page 14 of the extension request. (Iowa Department of Health and Human Services, June 1, 2016)
http://www.chcf.org/publications/2017/11/state-medicaid-waiver-resource?_cldee=am9obi5kdWJhc0BwcmVtaWVyc21pLmNvbQ%3d%3d&recipientid=contact-8c6467ad9362e7118132e0071b66ae41-9a97f1f1e37e4791818eab84e0bac4b6&esid=2d537429-01cb-e711-8129-e0071b6af0d1
This blog is truly extraordinary in all aspects.
ReplyDeletehttp://lifesolutionsct.com/medicare-supplement-plans-ct/