CHSE awarded contract to evaluate Oregon Medicaid's SUD residential treatment waiver

The $2m evaluation for the Center for Medicare and Medicaid Services will run through 2027

The Center for Health Systems Effectiveness has been awarded a contract to serve as an independent external evaluator for Oregon's Medicaid Section 1115 substance use disorder (SUD) waiver by the Oregon Health Authority.

About the Oregon SUD Waiver

Oregon's SUD waiver aims to increase identification, initiation, and adherence to treatment for Medicaid members with SUD by allowing Medicaid to reimburse for stays in Institutions of Mental Disease (IMDs). IMDs are residential facilities with more than 16 beds that are primarily engaged in providing diagnosis, treatment, or care of persons with mental diseases, which include SUDs. Before the waiver, IMD stays were paid out of the state’s general funds. The waiver was approved by CMS in 2021. 

Additionally, the waiver allows the state to receive Medicaid funding for housing and employment support services for individuals with SUD who have specific risk factors such as a risk of homelessness, domestic violence, or difficulty remaining employed due to mental or physical impairments.

About the evaluation

CMS requires a third-party evaluation of all Medicaid waivers. The evaluation performed by CHSE will include three reports: a midpoint assessment report, an interim report, and a summative report.

To understand outcomes from the SUD waiver, CHSE will perform quantitative analysis of Medicaid claims, comparing later years with a baseline from before waiver implementation. CHSE will also perform qualitative analysis of stakeholder interviews and partner feedback to understand context of the waiver implementation, including areas of success and barriers.