Advancing Medicaid Innovation, Evaluation, and Policy Implementation

At any given moment, between 60 million and 80 million Americans count on Medicaid and the Children's Health Insurance Program (CHIP) for health coverage. Recent changes to Medicaid policy related to eligibility, federal funding, and work requirements present opportunities for states, health systems, and program beneficiaries to explore new approaches and adapt existing processes.

AIR helps clients translate policy into practice, evaluate innovations, and improve the reach and effectiveness of Medicaid and CHIP programs. Over the past decade, AIR has conducted research, evaluation, and implementation projects for the Centers for Medicare & Medicaid Services (CMS), states, and nonprofit organizations. We bring deep expertise in policy analysis, data collection, program evaluation, and program operations.

AIR supports Medicaid and CHIP stakeholders across four key areas: payment and financing, quality measurement, innovation and demonstration models, and chronic disease prevention and management.

• Strengthening payment oversight and financing by improving transparency around states' supplemental payments for the Center for Medicaid and CHIP Services (CMCS), identifying data trends and quality concerns, and analyzing drivers of Medicaid hospital costs and payment policies. AIR also leads a Medicaid and CHIP Payment and Access Commission (MACPAC) hospital payment index technical expert panel to compare Medicaid payment rates across hospitals and states and develop recommendations for improvement.
  
• Measuring program quality and beneficiary experience through quality measure development, maintenance, and monitoring. AIR experts lead survey research efforts, including the CAHPS Home and Community-Based Services Survey (HCBS CAHPS), which gathers feedback from Medicaid enrollees on the quality of long-term services and supports they receive.
  
• Evaluating innovative models and demonstrations from design through implementation and assessment. AIR uses mixed-method research strategies to help partners improve health outcomes, reduce costs, and address evolving Medicaid needs. We support efforts to expand access to cell and gene therapies through cost negotiation, data analysis, and implementation monitoring. AIR also works with CMS, states, and drug manufacturers on the GENEROUS Model to improve prescription drug pricing options and expand access to needed medications.
  
• Addressing chronic disease through prevention and care management by supporting programs that increase access to care, strengthen care coordination, and promote health education. AIR experts partner with CMS on the BALANCE model to expand access to affordable GLP-1 medications alongside lifestyle support for Medicare and Medicaid beneficiaries.