School of Public Health lab awarded $12.6 million to continue Texas Medicaid 1115 Waiver Evaluation

Experts from the Texas A&M University School of Public Health have been awarded $12.6 million to continue their work as the independent evaluators for the Texas Medicaid 1115 Wavier for the third consecutive evaluation period. These faculty were selected twice before by Texas Health and Human Services, which oversees Medicaid in the state, to evaluate 1115 Waver efforts to improve health care in Texas.

The award is for a 10-year extension of the research team’s statewide evaluation of the Texas 1115 Healthcare Transformation and Quality Improvement Program Waiver (1115 waiver). This extension builds upon the work funded by a previous award of $5 million for the period 2018-2022, which was granted in fiscal year 2019. The renewal sought to improve health care access, quality and cost-effectiveness through three focus areas: Medicaid Managed Care, the uncompensated care system and a Delivery System Reform Incentive Payment program.

For that evaluation, the team analyzed a variety of health-related administrative data, Medicaid claims data, and developed and conducted surveys with Delivery System Reform Incentive Payment providers to assess health care access, quality and cost on Medicaid patients and the low-income, uninsured population in Texas. The data is analyzed on ViDaL (Virtual Data Library), the compliant research computing facility co-managed by the Population Informatics Lab, the High Performance Research Computing group, and the Privacy and Security Offices, all at Texas A&M. The team submitted its final evaluation report to Texas Health and Human Services in mid-March. The final report eventually will be submitted to the federal Centers for Medicare and Medicaid Services.

Hye-Chung Kum, PhD, director of the Population Informatics Lab in the Department of Health Policy and Management and lead researcher in all three evaluations, said the evaluations have provided School of Public Health faculty and students rich opportunities for applied research that also directly informs policies and practices in Texas.

“One example that goes beyond the report of this project is our active research portfolio on the use of emergency departments,” Kum said. “This not only has helped us train students in data science for health services research, but also has resulted in a doctoral dissertation and more than 15 peer-reviewed publications to date, many of which involve junior faculty who went on to attract additional funding.”

In addition, Kum said the lab has hired public health student research assistants and program graduates who will gain real-world, hands-on experience in preparation for careers in population health management.

Others participating in the next evaluation are Robert Ohsfeldt, PhD, Eva Shipp, PhD, and Qi Zheng, PhD, all School of Public Health faculty members associated with the Population Informatics Lab. Kum and Ohsfeldt have been part of the evaluation team since the first evaluation in 2011–2016, and Shipp and Zheng joined starting the second evaluation in 2018.

During the new contract period, from Sept. 1, 2023, to Aug. 31, 2032, the researchers will continue to analyze Medicaid claims data to assess progress on the Medicaid Managed Care programs and conduct surveys with providers in Texas. In addition, they will conduct new surveys and interviews with providers and with Managed Care Organizations and analyze new administrative data to assess the new directed payment programs and supplemental payment programs.