SHADAC Expertise

Medicaid and CHIP Policy

Medicaid and CHIP Policy

SHADAC has worked both independently and under contract to the Robert Wood Johnson Foundation (RWJF) and the Medicaid and CHIP Payment Access Commission (MACPAC) to monitor and analyze changes in the Medicaid and CHIP policy landscape such as Medicaid expansion, eligibility, enrollment, and renewal, quality measurement, as well as states’ waiver application, implementation, and evaluation. SHADAC faculty and staff have exceptional knowledge of Medicaid and CHIP, including knowledge from the perspective of state policymakers and program administrators, as well as operational issues at the federal and state levels.

Related SHADAC work
Click on any title below to learn more about the project.

Assessment and Synthesis of Selected Medicaid Eligibility, Enrollment, and Renewal Processes and Systems in Six States
SHADAC worked as a contractor for the Medicaid and CHIP Payment Access Commission (MACPAC) to conduct an assessment of Medicaid eligibility, enrollment, and renewal processes and systems in six study states—Arizona, Colorado, Florida, Idaho, New York, and North Carolina. Utilizing a multi-case study methodology as well as key informant interviews with state and local agency staff and advocacy organizations, SHADAC collected and synthesized data on Medicaid enrollment processes and systems for individuals whose income eligibility is based on Modified Adjusted Gross Income (MAGI) in order to assess the extent to which states were achieving desired goals such as program efficiency and a simplified beneficiary experience. As a follow up, SHADAC identified the risks that remain for both individuals and state agencies that cause eligible individuals to remain uninsured or lose Medicaid coverage and conducted interviews with key stakeholders nationally and in four states to obtain additional input on potential risk points and strategies to improve eligibility determination and renewal accuracy.

Addressing Social Determinants of Health through Behavioral Health-focused 1115 Waivers: Implementation Lessons from Six States
Through the Robert Wood Johnson Foundation’s (RWJF) “Research in Transforming Health” program, SHADAC researchers conducted a study to understand how three states—Illinois, Texas, and Washington—were addressing the needs of justice-involved populations through implementation of Section 1115 Medicaid waiver programs. The specific aim of the study was to identify promising practices and lessons learned related to the development, implementation, and management of these innovative behavioral health policies with the purpose of informing policy development in states considering similar 1115 waivers.

Evaluation of the Implementation of Section 1115 Medicaid Expansion Waivers
SHADAC was commissioned by the Medicaid and CHIP Payment and Access Commission (MACPAC) to conduct an analysis of how four states implemented Section 1115 Medicaid expansion waivers. SHADAC examined how these four states--Arkansas, Indiana, Iowa, and Michigan--approached the implementation of key provisions of their waivers, including exchange plan premium assistance, enrollee contribution requirements, health savings accounts, healthy behavior incentives, and graduated copayments for emergency department use.

Medicaid Quality Measurement for Special Populations
SHADAC conducted a comprehensive scan of state-level quality measurement initiatives related to home- and community-based services (HCBS) and behavioral health in Medicaid. SHADAC reviewed publicly available information on cutting-edge practices in quality measurement for these special populations and the status of measures currently in use in states. SHADAC prepared a synthesis of state measurement activity and challenges and recommendations for enhancing quality measurement in these areas. This work included a review of several of the core programs and documents relevant for this project (e.g., Federal Acquisition Institute [FAI] contracts, Managed Long-Term Services and Supports [MLTSS] reporting requirements, and measures related to assessing the quality of home- and community-based services).