Section 1115 of the Social Security Act gives states the authority to approve experimental or pilot projects that are likely to assist in better serving Medicaid populations. These demonstration projects, called 1115 Medicaid demonstration waivers, give states additional flexibility to design and improve their programs on the state level. CHSE serves as the independent external evaluator for state demonstration waivers in both Oregon and Washington.
In Oregon, the vast majority of Medicaid services are delivered through Coordinated Care Organizations (CCOs) – regionally based payers that are accountable for healthcare quality, access and spending through a global budget. CCOs integrate physical, mental, addiction and dental services for their members and provide tailored services and supports in the context of the communities they serve. CHSE served as the independent evaluator of the first CCO waiver (2012-2017) and continues to evaluate the progress of the CCO model with the Oregon Health Authority (OHA).
In partnership with qualitative investigators at the OHSU Department of Family Medicine, CHSE is assessing progress on the Washington State Health Care Authority's (HCA) 1115 Medicaid waiver, known as the Medicaid Transformation Project (MTP).