The following are examples of hypotheses that can be considered in the development of the evaluation and design: The 1115 SUD waiver will increase access to SUD treatment options to Indiana Medicaid members. The 1115 SUD waiver will increase provider enrollment for SUD treatment for Indiana Medicaid members. The 1115 SUD waiver will reduce readmission rates to emergency departments and inpatient hospital settings for Indiana Medicaid members who have had a previous admission for substance abuse treatment. The 1115 SUD waiver will increase the percentage of Indiana Medicaid members affected by substance abuse who seek treatment for substance abuse. The 1115 SUD waiver will promote the entire continuum of SUD treatment options. 2.4.1.1.b. Measures The draft evaluation design must discuss the outcome measures that shall be used in evaluating the impact of the demonstration during the period of approval, including: A description of each outcome measure selected, including clearly defined numerators and denominators, and National Quality Forum (NQF) numbers (as applicable). Identifying the measure steward organization responsible for providing the required measure information for the measure, making any necessary updates to the measure, and informing stakeholders about any changes made to the measures. The baseline value for each measure and the method by which the baselines were established. The sampling methodology for assessing these outcomes including the margin of error, confidence level and response distribution, and sample size. 2.4.1.1.c. Sources of Measures Measure sets could include CMS’s Core Set of Health Care Quality Measures for Children in Medicaid and CHIP, Consumer Assessment of Health Care Providers and Systems (CAHPS), the Initial Core Set of Health Care Quality Measures for Medicaid-Eligible Adults and/or measures endorsed by the National Quality Forum (NQF). 2.4.1.1.d. Evaluation Requirements
Annual Monitoring Report Further, payment for each of the following deliverables will be made in two increments as set forth in the Deliverable Payment Schedule Table below: Evaluation Design and Implementation Mid-Point Assessment* Interim Evaluation Report Summative Evaluation Report Table: Deliverable Payment Schedule Milestone Achieved % of Total Deliverable Due Draft deliverable approved by the State and submitted to CMS* 40% of the deliverable’s contract amount will be paid Final deliverable approved by CMS after incorporating CMS feedback* 60% of the deliverable’s contract amount will be paid. *Note: For the Mid-Point Assessment, the first milestone will be achieved when the draft deliverable is approved by the State, at which time the Contractor will be paid 40% of the deliverable’s contract amount. The second milestone will be achieved when the deliverable is approved by CMS, at which time the Contractor will be paid 60% of the deliverable’s contract amount. 3.1 Timeliness Performance As untimely completion of a deliverable has less value, the following Table lists the payments due to the Contractor for the Contractor’s untimely completion of a deliverable if the Contractor fails to complete and submit an acceptable deliverable by the respective deliverable’s Contractor Deadline set forth in Section 2.5. There will be an exception if the failure to complete the milestone can be attributed to the State's material delay or material failure to comply with its obligations. Table: Deliverable Timeline Timeliness Performance Untimely Delivery Measurement Payment Due to Contractor Delivery more than 2 business days after Contractor Deadline (Deliverable Cost) – (A percentage, not to exceed 5%, of the Deliverable Cost, reasonably representing the decreased value provided to the State due to the late delivery) Delivery for each week (5 business days) after the Contractor Deadline + 2 days (Deliverable Cost) – (A percentage, not to exceed 5%, of the Deliverable Cost, reasonably representing the decreased value provided to the State due to the late delivery)