Liu Harry H, Dick Andrew W, Qureshi Nabeel, Baxi Sangita M, Roberts Katherine J, Ashwood J Scott, Guerra Laura A, Ruder Teague, Shih Regina A
Rand Health Q. 2022 Jun 30;9(3):5. eCollection 2022 Jun.
The broad goals of New York State's Medicaid Section 1115 Waiver are to enroll a majority of Medicaid beneficiaries into managed care, increase access and service quality, and expand coverage to more low-income New Yorkers. The RAND Corporation was competitively selected as the independent evaluator to assess two components under this 1115 Demonstration Waiver: the Managed Long-Term Care (MLTC) program and the 12-month continuous eligibility policy, which guarantees enrollees Medicaid coverage regardless of changes in income in the 12 months after eligibility determination and enrollment. This final interim evaluation examines whether these two components have helped achieve the program's goals. The RAND team's analyses show that the Demonstration has expanded access to managed care through mandatory MLTC enrollment and 12-month continuous eligibility. The team found no evidence of a significant change in patient safety or quality of care. The authors note that, although this means that there is no evidence the Demonstration achieved the goal of improving quality of care, increasing access without compromising quality of care is a success in its own right.
纽约州医疗补助计划第1115条豁免条款的总体目标是让大多数医疗补助受益人加入管理式医疗，增加医疗服务可及性并提升服务质量，以及将覆盖范围扩大至更多低收入纽约人。兰德公司在竞争中脱颖而出，被选为独立评估机构，以评估这项1115示范豁免条款下的两个部分：管理式长期护理（MLTC）计划以及为期12个月的连续参保资格政策，该政策确保参保人在资格确定和参保后的12个月内，无论收入如何变化，均可享受医疗补助。这份最终中期评估报告考察了这两个部分是否有助于实现该计划的目标。兰德团队的分析表明，该示范项目通过强制参保MLTC计划和12个月的连续参保资格扩大了管理式医疗的可及性。团队没有发现患者安全或医疗质量发生重大变化的证据。作者指出，虽然这意味着没有证据表明该示范项目实现了改善医疗质量的目标，但在不降低医疗质量的前提下增加可及性本身就是一项成就。
