JAI is highly experienced in providing assistance to states that are applying for waivers to introduce innovative, coordinated and integrated delivery systems for both seniors and persons with disabilities.

Phase 1: Concept Development. During the concept development phase JAI works with state policy analysts and strategic planning staff to identify the goals of the waiver, and to develop an analysis specifically designed to learn the time dynamic of program enrollment and the costs of care from the historical experiences of the target population. The results of this analysis form the building blocks for addressing the expected Medicaid and Medicare costs in lieu of the proposed program. In this stage JAI uses historical Medicaid and Medicare utilization and enrollment data to prepare a population model that identifies beneficiaries who are likely to benefit from the waiver program, and generate comparative profiles that compare and contrast the target population to other Medicaid eligibles. Data for the target and comparison populations is prepared for base and follow-up years, and multivariate econometric methods are applied to measure the underlying factors in the baseline period that are associated with the observed costs of care in the follow-up period.

Phase 2: Impact Analysis. The second stage of the analysis is focused on developing a five-year projection of program enrollment that is based on the annual prevalence of sensitive populations, their expected longevity, frequency of adverse outcomes and their costs of care. The tipping point for budget neutrality is the comparison of projected costs in the Phase I analyses versus the cost projection developed in the Phase II projections of the program. In essence the overall analysis presents a comparison between expected costs of the program in the target population with and without the introduction of the waiver.

Learn more