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Innovations in section 1115 demonstrations.

J Jordan1, A Adamo, T Ehrmann

  • 1aadamo@hcfa.gov

Health Care Financing Review
|December 26, 2002
PubMed
Summary
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States leverage Section 1115 waivers for Medicaid innovation, exploring new approaches in outreach, eligibility, benefits, and care delivery. Future challenges for these demonstration projects are also examined.

Area of Science:

  • Health Policy
  • Public Health
  • Healthcare Administration

Background:

  • Section 1115 of the Social Security Act provides states with research and demonstration authority.
  • This authority allows states to test innovative approaches within their Medicaid programs.

Purpose of the Study:

  • To examine how states utilize Section 1115 waivers.
  • To identify innovations in various aspects of Medicaid programs developed through these waivers.

Main Methods:

  • Analysis of state-submitted Section 1115 demonstration project proposals and approved waivers.
  • Review of literature and reports on Medicaid innovation.

Main Results:

  • States have implemented innovations in outreach and enrollment strategies.

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  • Demonstrations have addressed eligibility requirements, benefit packages, and payment methodologies.
  • Initiatives have also focused on access to care, quality assurance, safety net providers, and special needs populations.

    • Conclusions:

    • Section 1115 authority offers significant flexibility for state-led Medicaid reform.
    • Ongoing challenges exist for all stakeholders involved in Medicaid demonstration projects.
    • Continued evaluation is crucial to understand the long-term impact of these innovations.