Online Program

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Tuesday, January 7
Tue, Jan 7, 7:45 AM - 8:45 AM
Pacific D
Continental Breakfast & Poster Session II

Meeting the New Federal Guidance to Conduct Medicaid Demonstration Waiver Evaluations: The Arkansas “Private Option” Evaluation Exemplar (307807)

*Anthony Goudie, Arkansas Center for Health Improvement 
Kanna Lewis, Arkansas Center for Health Improvement 
Bradley C Martin, College of Pharmacy 
Joseph Thompson, Arkansas Center for Health Improvement 

Keywords: federal policy evaluation guidelines

In March 2019, the Centers for Medicare & Medicaid Services (CMS) issued technical guidance to states conducting Section 1115 Medicaid demonstration waiver evaluations. The new guidance outlines rigorous evaluation methods covering hypotheses, research questions, outcome measures and analytic approaches. This presentation includes the evaluation framework established for the Arkansas Health Care Independence Program (“Private Option”) Section 1115 demonstration waiver evaluation that served as the exemplar for the new CMS guidance. We constructed hypotheses to test counterfactual scenarios, adopted national quality indicator metrics to assess outcomes, implemented geospatial analytics to study access to care, and utilized quasi-experimental methods including propensity score matching and regression discontinuity (RD) to test differences in access, utilization and quality of care between adults with Medicaid coverage and those with premium assistance assigned to private qualified health plans (QHP). RD used an exceptional healthcare needs screener composite score forcing variable with an a priori defined cut-point established for a sharp programmatic assignment to Medicaid or a QHP.