Medicaid Section 1115 MidPoint Evaluation

Section 1115 waivers give states flexibility to test new approaches to managing and delivering care to Medicaid and Children's Health Insurance Program populations. In 2012, Oregon launched a demonstration waiver program that redesigns the state’s Medicaid delivery and payment system. The goals were to improve quality of care while reining in costs through (1) increased care coordination; (2) alternative payment methodologies; (3) integrated physical, behavioral, and oral health; (4) administrative simplifications; (5) greater use of flexible and nontraditional Medicaid services; and (6) effective implementation of innovations and best practices.

The Medicaid program established coordinated care organizations (CCOs) to deliver care and serve as a single point of accountability for access, quality, and outcomes for their Medicaid beneficiaries. CCOs are community-based organizations comprised of managed care entities, providers of care, and community members.

Our study involves formative and summative evaluations to analyze the extent to which changes were implemented as part of the state’s system transformation, as well as what changes in outcomes for beneficiaries were brought about by the waiver.