Hawaii Advances Medicaid Innovation with Section 1115 Demonstration Submission: Summary of Key Provisions and Insights

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AUTHOR – ATI Advisory


Johanna Baraza Cannon and Morgan Craven, Directors in the State Program and Policy Practice at ATI Advisory, presented an overview of Hawaii’s Medicaid Section 1115 demonstration renewal process.  

Key Components of Hawaii’s 1115 Renewal  

Hawaii’s renewal aims to build on previous state accomplishments to improve health outcomes, maintain appropriate healthcare utilization, and address social determinants of health. 

The renewal included expanded services focused on innovation in care delivery addressing both the medical and social needs of beneficiaries. These provisions were designed with significant community engagement and included nutrition and housing supports, health-related social needs infrastructure funding, continuous eligibility, contingency management, pre-release services for justice-involved individuals, and designated state health program funding, 

Lessons Learned    

The speakers stressed the need for flexibility and effective project management in adapting to changes in the Centers for Medicare and Medicaid Services’ (CMS) expectations. Key factors that drove Hawaii’s success include project governance; state leadership involvement; constant community and CMS engagement; rigorous research on precedent (in Hawai’i and other states); budget neutrality; and partnerships with subject matter experts including policymakers, academics, and evaluators.  

Insights from Hawaii’s Medicaid Director

Judy Mohr Peterson, Hawaii’s Medicaid Director, shared insights on the renewal process. She emphasized the importance of collaboration with subject matter experts, effective project coordination, flexibility in decision-making, awareness of CMS rules and regulations, and community engagement. Peterson expressed excitement about the comprehensive nature of Hawaii’s renewal and its potential to address the state’s unique healthcare needs. 

The conversation highlights challenges, successes, and lessons learned that could be beneficial for other states undertaking similar initiatives. 

Want to know more? Don’t miss our recent interview with Judy Mohr Peterson.

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