Accepted for/Published in: JMIR Research Protocols
Date Submitted: Dec 7, 2018
Open Peer Review Period: Dec 11, 2018 - Dec 25, 2018
Date Accepted: Jul 5, 2019
(closed for review but you can still tweet)
A protocol for analysis of home and community-based 1915(c) Medicaid waivers: Towards family-oriented taxonomy for assessment of children’s waivers
ABSTRACT
Background:
Children with medical complexity are a group of children with multiple chronic conditions and functional limitations that represent the highest health care utilization and often require a substantial number of home and community-based services (HCBS). In many states, HCBS are offered to target populations through 1915(c) Medicaid waivers. To date, there has not been standard methods or approaches to evaluate or compare 1915 (c) waivers across states for children.
Objective:
The purpose of this analysis was to develop a systematic and reproducible approach to evaluate 1915(c) Medicaid waivers for overall coverage for children.
Methods:
Data elements were extracted from Medicaid 1915(c) approved waivers applications for all included waivers targeting any pediatric age range through October 31, 2018. Normalization criteria were developed and an aggregate overall coverage score calculated for each waiver.
Results:
142 waivers across 45 states were included in this analysis. Through this process, it was recognized that existing adult HCBS taxonomy may not always be applicable for child and family-based service provision. Even though there was uniformity in the Medicaid applications, there was great heterogeneity how waiver eligibility, transition plans, and wait lists were defined.
Conclusions:
We present methods and analyses for the first study to our knowledge to systematically evaluate 1915 (c) Medicaid waivers targeting CMC that can be replicated without the threat of missing data. Clinical Trial: n/a non-human subjects research; policy analysis
Citation
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