Chapter 3 discusses the challenges states and CMS face in conducting and using evaluations of demonstrations approved under Section 1115 of the Social Security Act.
Beginning with background information on the use of Section 1115 in Medicaid and limitations in past evaluation processes, the chapter describes recent steps that the Centers for Medicare & Medicaid Services (CMS) has taken to improve the quality of state-led evaluations; reviews challenges states face in planning and conducting evaluations; and discusses the need for robust evaluations to inform decision making at the state and federal levels. It relies heavily on the perspectives of an expert roundtable of state and federal Medicaid officials, evaluators of state demonstration programs, researchers, and other stakeholders convened in November 2019.
The Commission does not identify a need for further legislative or regulatory steps to improve Section 1115 evaluations at this time but will continue to monitor how states and CMS carry out evaluations use findings in decision making.
From: March 2020 Report to Congress on Medicaid and CHIP