The Centers for Medicare & Medicaid Services (CMS) has formalized and strengthened requirements for evaluation of state Section 1115 Medicaid demonstrations, including new demonstration programs being permitted by the current administration that are both unprecedented and controversial. The increased scientific rigor reflected in this new guidance to states is essential to produce valid and reliable research findings to inform future policymaking in Medicaid.

States are still in the early stages of designing their evaluations to meet the new federal guidance, but many state officials and researchers acknowledge that undertaking these evaluations will have implications for how evaluations are designed, budgeted and implemented.