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Medicaid Waiver and Program Evaluation
HSAG provides rigorous analyses to assess the impact of Medicaid waivers and other programs on healthcare quality, access, timeliness, and cost.
Overview
HSAG has served as a Medicaid Waiver Independent Evaluator for almost 20 years.
Medicaid waivers give states the flexibility to modify certain Medicaid requirements in order to test and implement innovative programs that address specific healthcare challenges. Federal requirements call for an independent evaluation to determine whether these programs are achieving their intended objectives. As an independent Medicaid waiver evaluator, HSAG applies rigorous quantitative and qualitative methods to assess where waiver programs have met, exceeded, or fallen short of their stated goals—providing states with a clear, objective understanding of program performance and impact.
By The Numbers
Our Impact
Medicaid 1915b Waiver Independent Evaluator for
8 States
Medicaid 1115 Waiver Independent Evaluator for
7 States
Why HSAG
HSAG has the capability and experience to assist states with every phase of the evaluation process.
HSAG brings deep, end-to-end expertise to Medicaid Section 1115 and 1915 waiver evaluations, supporting states through every phase of the evaluation lifecycle. Our work spans the full continuum of evaluation activities—from the design and CMS approval of evaluation plans, through mid-point assessments and continuous monitoring, to the development of interim and summative reports that meet rigorous federal standards.
HSAG has conducted waiver evaluations across a wide range of program types, populations, and delivery models, including complex, multi-initiative demonstrations and targeted programs focused on priority populations. This breadth of experience, combined with our role as a nationally recognized Quality Improvement Organization (QIO) and External Quality Review Organization (EQRO), enables us to bring both methodological rigor and real-world program insight to every evaluation.
Our multidisciplinary team of policy experts, statisticians, economists, clinicians, and data scientists partners closely with state agencies to produce evaluations that are not only CMS-compliant, but also meaningful for policymaking and program refinement. HSAG helps states answer critical questions such as:
- What is the measurable impact of the waiver program on access, quality, outcomes, and cost?
- Is the program effectively reaching and serving its intended populations?
- Where are there opportunities to strengthen implementation, target interventions, or adjust program strategy?
By combining advanced quantitative and qualitative methods with a strong understanding of Medicaid policy and operations, HSAG delivers waiver evaluations that go beyond reporting requirements—providing actionable insights to support continuous improvement and informed decision-making.
Commitment to Scientific Rigor
We maintain a high standard of scientific rigor across a wide range of quantitative and qualitative methods to match the needs of each evaluation. HSAG’s evaluation reports provide a clear and concise explanation of program impact, policy implications, and actionable recommendations to ensure the program is functioning as intended.
Multidisciplinary Expertise
Our Program Evaluation Team includes experts in data science, statistics, public health, economics, clinical science, and health policy (with specific focus on policy areas relevant to waiver programs).
Statistical Methods
HSAG employs advanced mixed-methods evaluation, combining rigorous quantitative modeling with qualitative insights, to ensure each waiver program is evaluated using the most appropriate and scientifically sound measurement tools.
Robust Analyses
HSAG generates counterfactual hypotheses that allow for causal inference, removing trends and confounding factors to isolate and identify program impacts.
Evaluation Approach
HSAG extends its role as an independent evaluator beyond traditional program evaluation by translating results into clear policy insights and actionable recommendations that help states strengthen implementation and continuously improve program performance.
Quantify Impact
HSAG integrates advanced quantitative modeling with qualitative analysis to isolate waiver-specific impacts, separating program effects from external influences and generating actionable, policy-relevant insights.