Evaluation of the NJFamilyCare Comprehensive 1115 Waiver Demonstration Renewal (“Waiver 2”)

Medicaid demonstration waivers authorize states to test innovative strategies for improving services, even when the innovations depart from federal program standards. The NJ Medicaid program has designated CSHP to conduct the federally required evaluation of its comprehensive waiver. CSHP is studying the impact of waiver policy changes on patient access to care, quality of care, and costs. The policy changes include: 1) a shift of long-term services and supports (LTSS) from fee-for-service payment to the package of services for which Medicaid managed care plans are responsible; 2) expansion of income eligibility and administrative simplifications for beneficiaries in enrolling managed LTSS; 3) provision of additional home and community-based services, and expansion of eligibility for these services among children with intellectual and developmental disabilities and severe emotional disturbance; 4) implementation of premium assistance for Medicaid beneficiaries who have access to employer-sponsored health insurance; 5) expansion of access to and benefits for substance use disorder services; and 6) the extension of the NJ Delivery System Reform Incentive Payment hospital population health improvement program. The evaluation design uses quantitative and qualitative techniques including analysis of Medicaid claims and managed care encounter data, and stakeholder interviews. This project is supported by a grant from the New Jersey Department of Human Services Division of Medical Assistance and Health Services.