Medicaid Demonstrations – GAO Calls for CMS to Require State to Conduct More Frequent Evaluations

The Government Accountability Office (GAO) issued a report in January 2018 finding that the Center for Medicare and Medicaid Services (CMS) is “missing an opportunity to inform important federal and state policy discussions” by not requiring states to conduct more frequent and more thorough evaluations of Medicaid demonstration programs. One example GAO gives of missed opportunities is data gaps that occur because CMS allows states to wait until demonstrations have fully expired to evaluate them, instead of conducting periodic evaluations at the end of the demonstrations’ 3-5 year cycles – that is to say, at the point where they could be renewed. This means policy-makers might have to wait over a decade to know whether a program is effective.

As a remedy, GAO recommends that “CMS: (1) establish written procedures for requiring final evaluation reports at the end of each demonstration cycle, (2) issue criteria for when it will allow limited evaluations of demonstrations, and (3) establish a policy for publicly releasing findings from federal evaluations of demonstrations.”

Click here to access fast facts, a 1-page summary, and the full report.