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Section 1115 Medicaid demonstration waivers provide states an avenue to test new approaches in Medicaid that differ from federal program rules. Waivers can provide states considerable flexibility in how they operate their programs, beyond what is available under current law, and can have a significant impact on program financing. As such, waivers have important implications for beneficiaries, providers, and states. While there is great diversity in how states have used waivers over time, waivers generally reflect priorities identified by states and the Centers for Medicare and Medicaid Services (CMS). Looking ahead, states are likely to continue to request waivers to implement provisions not allowed under current law. The Trump administration recently signaled in a letter to governors that CMS would be open to considering waiver requests concerning work requirements in Medicaid, for instance, and some states may wish to experiment with premiums and cost-sharing requirements. This page highlights key resources examining Section 1115 waivers and, farther down, also provides the standard search result page for a site-wide search on the “waivers” tag.

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The Henry J. Kaiser Family Foundation

Interactive Tool Provides an Overview of Delivery System and Payment Reform Efforts in Medicaid Programs

A new interactive tool from the Kaiser Family Foundation provides an overview of the increasing number of delivery system and payment reform efforts that are underway as alternatives to traditional fee-for-service arrangements in state Medicaid programs across the country. Users can scroll over the interactive map and see highlights of…

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The Henry J. Kaiser Family Foundation

Early Insights from Commonwealth Coordinated Care: Virginia’s Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

Virginia is among the early states to launch a 3-year capitated financial alignment demonstration to integrate payments and care for beneficiaries who are dually eligible for Medicare and Medicaid. This case study describes the early implementation of the demonstration based on a diverse group of stakeholder interviews.

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The Henry J. Kaiser Family Foundation

Early Insights From Ohio’s Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

Ohio is among the early states to launch a 3-year capitated financial alignment demonstration to integrate payments and care for beneficiaries who are dually eligible for Medicare and Medicaid. This case study describes the early implementation of the demonstration based on a diverse group of stakeholder interviews.

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The Henry J. Kaiser Family Foundation

Early Insights from One Care: Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries

Massachusetts is among the early states to launch a 3-year capitated financial alignment demonstration to integrate payments and care for beneficiaries who are dually eligible for Medicare and Medicaid. This case study describes the early implementation of the demonstration based on a diverse group of stakeholder interviews.

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The Henry J. Kaiser Family Foundation

Key Themes From Delivery System Reform Incentive Payment (DSRIP) Waivers in 4 States

Building on an earlier brief that provided an overview of the components of DSRIP waivers, this analysis relied upon interviews with stakeholders to identify emerging trends and themes from DSRIP waivers in four states – California, Massachusetts, New York and Texas. It highlights that DSRIP waivers are spurring major change in relationships among providers; allowing providers to launch new initiatives aimed at improving care and reducing costs; and fostering a stronger focus on the social service needs of Medicaid beneficiaries. At the same time, the rapid pace of implementation is straining the ability of stakeholders to keep pace, including consumer advocates who are hard-pressed to track and respond to the DSRIP-driven changes that are fundamentally re-shaping the way that care is delivered to Medicaid beneficiaries.

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Web Briefing for Journalists: Key Issues Around Medicaid Expansion Efforts in the States

To help reporters understand the national landscape and issues surrounding the Medicaid expansion, KFF holds a web briefing exclusively for journalists with Medicaid experts Laura Snyder and Robin Rudowitz.

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The Henry J. Kaiser Family Foundation

An Overview of Actions Taken by State Lawmakers Regarding the Medicaid Expansion

The ACA Medicaid expansion has garnered different responses from statelawmakers – Democratics and Republicans as well as governors and legislatures. While it does not cover how every state has enacted the ACA Medicaid expansion, this fact sheet highlights some of the different actions state lawmakers have taken in response to the ACA Medicaid expansion.

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The Henry J. Kaiser Family Foundation

Proposed Medicaid Expansion in Tennessee

This fact sheet describes Tennessee’s 1115 waiver demonstration project, Insure Tennessee, which expands the State’s Medicaid program under the Affordable Care Act.

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The Henry J. Kaiser Family Foundation

Proposed Medicaid Expansion in Utah

This fact sheet provides a summary of the proposal to expand Medicaid in Utah. This has not been officially submitted to CMS and needs state legislative approval before it could be implemented.

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The Henry J. Kaiser Family Foundation

Key Themes in Capitated Medicaid Managed Long-Term Services and Supports Waivers

This issue brief analyzes key themes in 19 capitated § 1115 and § 1915(b)/(c) Medicaid managed long-term services and supports (MLTSS) waivers approved to date by the Centers for Medicare and Medicaid Services (CMS) with a focus on covered populations and services, provisions aimed at expanding beneficiary access to HCBS, beneficiary protections, and quality measurement and oversight.

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Filling the need for trusted information on national health issues, the Kaiser Family Foundation is a nonprofit organization based in Menlo Park, California.