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Demonstration Approval Period: October 1, 2024 through September 30, 2029 Page 28 of 43

and in alignment with applicable CMS evaluation guidance and technical assistance, for the demonstration policy components. The evaluation is expected to use applicable demonstration monitoring and other data on the provision of and beneficiary utilization of preventive services. Proposed measures should be selected from nationally-recognized sources and national measure sets, where possible. Measures sets could include those from the Dental Quality Alliance;2 CMS’s Core Set of Children’s Health Care Quality Measures for Medicaid and CHIP (Child Core Set) and the Core Set of Adult Health Care Quality Measures for Medicaid (Adult Core Set) collectively referred to as the CMS Child and Adult Core Measure Sets for Medicaid and CHIP; Consumer Assessment of Health Care Providers and Systems (CAHPS); the Behavioral Risk Factor Surveillance System (BRFSS) survey; and/or measures endorsed by National Quality Forum (NQF).

CMS underscores the importance of the state undertaking a well-designed beneficiary survey and/or interviews to assess, for instance, beneficiary understanding of and experience with the demonstration, and beneficiary experiences with access to and quality of care. In addition, the state is strongly encouraged to evaluate the implementation of the demonstration components in order to better understand whether implementation of certain key demonstration policies happened as envisioned during the demonstration design process and whether specific factors acted as facilitators of—or barriers to—successful implementation. Implementation research questions can also focus on beneficiary and provider experience with the demonstration. The implementation evaluation can inform the state’s crafting and selection of testable hypotheses and research questions for the demonstration’s outcome and impact evaluations and provide context for interpreting the findings.

Finally, the state must accommodate data collection and analyses stratified by key subpopulations of interest (e.g., by sex, age, race/ethnicity, primary language, disability status, and geography), and by demonstration component, to the extent feasible. Such stratified analyses will provide a fuller understanding of existing disparities in access to and quality of care and health outcomes and help inform how the demonstration’s various policies might support reducing such disparities.

57. Interim Evaluation Report. The state must submit an Interim Evaluation Report for the completed years of the demonstration, and for each subsequent extension of the demonstration, as outlined in 42 CFR 431.412(c)(2)(vi). When submitting an application of the demonstration, the Interim Evaluation Report should be posted to the state’s Medicaid website with the application for public comment.

a) The Interim Evaluation Report, in alignment with the CMS-approved Evaluation Design, will discuss evaluation progress and present findings to date.

b) For demonstration authority or any components within the demonstration that

2 https://www.ada.org/resources/research/dental-quality-alliance/dqa-dental-quality-measures