In 2013, Abt Global completed a qualitative evaluation for the Medicaid and CHIP Payment and Access Commission (MACPAC) of demonstration and program waivers as well as the state-offered alternatives to waivers. The evaluation examined the statutory, regulatory, and policy guideline bases of the waivers and alternatives as well as their application and approval processes.

Abt, with partners Bailit Health Purchasing and the Muskie School of Public Service, conducted a systematic review of existing waiver, demonstration and state plan authorities and engaged with field experts and other stakeholders in structured interviews. Abt then distilled findings from both sources to produce a report outlining several policy options to streamline or otherwise improve the current waiver process.

Abt also produced an evaluation memorandum that summarized the:

• History and evolution of evaluations and assessments under three different waiver authorities;
• Changes in the restrictions and requirements applied to applications/renewals over time; and
• Extent to which these assessments are publicly available.