CMS’ latest Physician Fee Schedule (PFS) proposed rule includes a health equity adjustment to quality performance, suggesting the federal agency recognizes inequities exist among ACOs serving safety-net populations, but is it the right approach?

A core element of all Medicaid Section 1115 “research and demonstration” waivers is an evaluation of the demonstration program and its efficacy in meeting the demonstration’s goals. Historically, however, Section 1115 waiver evaluations have been an afterthought for states and CMS, limiting their ability to inform future Medicaid policy and financing approaches.