Medicaid Waiver Design & Evaluation Services
To better meet residents' needs, states apply for federal waivers to develop innovative and flexible approaches within their Medicaid programs to improve quality, expand allowable coverage, and control costs. We offer highly specialized expertise to navigate both the high-level issues and deep-in-the weeds modeling needed for waiver processes.
What Challenges You
State agencies need the agility to leverage highly specialized experts who can navigate both the broad issues and deep-in-the weeds modeling needed for waiver processes. They need access to independent data scientists and statisticians who can objectively evaluate whether the waiver initiatives improve patient care and outcomes, enhance efficiency, and are financially sustainable—so they can demonstrate success and ensure continued funding.
Why Choose Us
Our Medicaid waiver design and evaluation expertise is deep—and unmatched. In partnership with state agencies, we navigate waiver processes from start to finish. In particular, we have significant expertise in guiding state Medicaid agencies through the process of obtaining demonstration waivers under Section 1115 and home- and community-based services (HCBS) waivers under Section 1915 (c).
We also offer independent evaluators who bring academic-level rigor to the methods required for high-profile Medicaid demonstration evaluations. No matter where you are in the waiver process—from procurement and design to implementation and evaluation—we’ll empower you to convert pioneering waiver demonstrations into sustainable, lasting programs.
How We Can Help
1We help states develop innovative approaches within their Medicaid programs, and support those responding to the additional flexibility authorized Affordable Care Act provisions.
2We offer independent, rigorous evaluations for Medicaid waivers so agencies can provide clear data and continue to receive critical funding.
3Our team has also consulted with states applying for Balancing Incentive Program funding to promote a more diverse array of long-term services and supports for those eligible.
Innovation, to Achieve Higher-Value Care
For one Medicaid agency, we evaluated a 1115 waiver aimed at transforming care delivery by focusing on enrolling eligible individuals in insurance coverage, delivering integrated, coordinated care to members, and ensuring providers were held accountable for the quality and total cost of that care. Our work proved that the waiver program expanded coverage of people with no insurance to close a significant gap in service and impacted over 1 million Medicaid members enrolled into Accountable Care Organizations (ACOs) in the state.