CSHP Medicaid-Related Portfolio
Evaluating the Impacts of NJ Section 1115 Demonstrations
Since 2012, Rutgers Center for State Health Policy (CSHP) has served as the independent evaluator for the NJ FamilyCare Comprehensive Demonstration, a Section 1115 Medicaid waiver demonstration initiative developed by the New Jersey Division of Medical Assistance and Health Services (DMAHS) and approved by the US Centers for Medicare and Medicaid Services (CMS) for three successive periods – 2012-2017, 2017-2022 (extended to March 2023), and 2023-2028.
Distinguished Professor Joel Cantor serves as principal investigator for the demonstration evaluation, with co-investigators among the Center’s faculty and associates (currently including Ann Nguyen, John Palatucci, Hillary Samples, Amanda Spishak-Thomas, and Dan Treglia). Until 2023, the evaluation was led by Sujoy Chakravarty. Please contact Jennifer Farnham, Research Manager, with any questions about the evaluation.
The §1115 demonstrations have been central to the evolution of New Jersey’s Medicaid program. CSHP’s evaluations of these waivers have bolstered its robust analytic capacity and partnership with the state have bolstered the evaluations of these waivers.
Current Waiver Evaluation: 2023-2028
CSHP has been selected by DMAHS to evaluate the 1115 NJ FamilyCare Waiver Demonstrations, the most recent of which was approved on October 16, 2025. The current evaluation was approved by the NJ Department of Human Services, Division of Medical Assistance and Health Services and then by the US Department of Health and Human Services, Centers for Medicare and Medicaid Services on October 16, 2025.
New Jersey’s Demonstration operates under §1115 waiver authority, subject to Specific Terms and Conditions (STC), which set out requirements of the evaluation. The approved Evaluation Plan and supporting documentation can be found here.
The table below describes the thirteen components of the current NJ FamilyCare Waiver Evaluation approved by CMS. The first twelve components represent expansions to NJ FamilyCare’s usual benefits and eligibility criteria. The last component synthesizes an analysis of costs, spending, and savings related to all expansion components. CMS may add other components to this waiver evaluation in the future.
Table of Waiver Components: 2023-2028
Component | Description |
| Adjunct Services Autism Spectrum Disorder (ASD) Pilot | Added services are offered to enhance community inclusion and engagement for beneficiaries. |
| Children’s Support Services Programs (CSSP) for children with severe emotional disturbance (SED) and intellectual and developmental disabilities (I/DD) | Includes two expansions: Disregarding parental income when determining Medicaid eligibility for children/youth with SED or I/DD, and implementation of existing waiver authority policies for children, youths, and young adults with I/DD. |
| Postpartum Eligibility Extension | Extends postpartum coverage from 60 days to 12 months without the requirement to redetermine eligibility after the end of pregnancy. |
| New Jersey Home Visiting Pilot (NJHV) Program | Supports pregnant or postpartum individuals and their families with New Jersey’s home visiting network, implemented by the NJ Department of Children and Families (NJDCF). |
| Medically Indicated Meals Pilot | Managed Care Organizations contract with meal preparation vendors to provide medically indicated meals to pregnant people with pre-existing or gestational diabetes. |
| Continuous Eligibility for MAGI Adults | Eligible beneficiaries aged 19 to 64 with incomes up to 138% FPL may remain enrolled for 12 months, regardless of income fluctuations. |
| Community Health Workers (CHW) Pilot Program | Medicaid Managed Care Organizations are building pilot programs utilizing CHWs to assist members at-risk of or with chronic conditions. |
| Tenancy and Housing Supports | Housing strategy that incorporates enhancements to infrastructure, coverage for additional services, and coordination across State and community resources involved in the provision of health and housing services. |
| Opioid Use Disorder (OUD)/Substance Use Disorder (SUD) Program | New Jersey’s OUD/SUD program has been extended to the current §1115 demonstration in combination with additional behavioral health services. |
| Adult IDD Services: Supports and Community Care Program | Extends ongoing policies and programs affecting adults with IDD, including the Supports Program and the Community Care Program (CCP). |
| Managed Long-Term Services and Supports (MLTSS) Program | Extends community and facility-based long-term care services that were moved into managed care contracts, with some enhanced benefits. |
| Administrative Simplifications for LTSS | Qualified Income Trusts for higher-income individuals created a new eligibility pathway for long-term care services in home and community settings. Attestations allow lower-income individuals to qualify for Medicaid with reduced administrative burden. |
| Demonstration Cost Assessment | Analysis of administrative costs, utilization spending and savings, as well as uncompensated care expenditures and savings, as a result of the waiver programs. |
Past Waiver Evaluations
2017-2023
Key Components of the Evaluation
Articles and Presentations
- Lloyd, K., Chakravarty, S., Brownlee, S., Farnham, J. & Cantor, J.C. (2020). “Hospital Responses to DSRIP Program Reforms in New Jersey.” The American Journal of Accountable Care 8(2): 4-12.
Reports Not Yet Approved by CMS or State; Dates Reflect Initial Submission to State Reviewers:
- Examining the Effect of the NJ FamilyCare Comprehensive Demonstration on Access to Care, Quality, and Cost of Care: Draft Summative Evaluation Report (August 2025, evaluation plan shown with interim report below)
- Draft Summative Evaluation of the NJ FamilyCare 1115 Substance Use Disorder Demonstration (March 2025, evaluation plan shown with interim report below)
Reports Approved by CMS or State:
- Analysis of the Children’s Health Insurance Program (CHIP) Continuous Coverage Provision to Examine Enrollment and Access to Care and Quality (August 2025, includes evaluation plan)
- Interim Evaluation of the NJ FamilyCare 1115 Substance Use Disorder Demonstration (August 2022, includes evaluation plan)
- Examining the Effect of the NJ FamilyCare Comprehensive Demonstration on Access to Care, Quality, and Cost of Care: Interim Evaluation Report (August 2022, includes evaluation plan)
- The NJ FamilyCare Section 1115 Opioid and Substance Use Disorder Demonstration Program: Midpoint Assessment (January 2022)
- A Final Evaluation of the New Jersey Delivery System Reform Incentive Payment (DSRIP) Program: Assessing Program Impact on Outcomes and Cost-Effectiveness (December 2021)
- Evaluation of the New Jersey DSRIP Program: Findings from the Third Round of Stakeholder Interviews (September 2020)
- Stakeholder Feedback on Implementation of the Managed Care Expansion in Long-Term Services and Supports (Round 3, June 2020)
2012-2017
Key Components of the Evaluation
Articles and Presentations
- Chakravarty, S., Lloyd, K., Farnham, J. & Brownlee, S. (2019). “Medicaid DSRIP in New Jersey: Tradeoffs between Broad Hospital Participation and Safety Net Viability.” Journal of Health Politics, Policy and Law 44(5): 789-806.
- Chakravarty S., and Lloyd K., "Evaluating the New Jersey Hospital DSRIP Program: Policy reforms in safety net delivery system transformation and financing", American Society of Health Economists Conference, Washington DC, 2019.
- Farnham, J., Chakravarty, S., Lloyd, K. Care Management for Long-Term Care Beneficiaries: New Jersey’s Move to Managed Care. Paper presented at “Consequences of Change in Healthcare for Organizations, Workers, and Patients,” a conference sponsored by the School of Management and Labor Relations at Rutgers University and the School of Industrial and Labor Relations at Cornell University, held at Rutgers January 9-11, 2019.
- Chakravarty S., DeLia D., Lloyd K., "Assessing the impact of state policies transitioning long term care services and supports from Fee-for-Service to managed care", American Society of Health Economists Conference, Atlanta, 2018.
- Chakravarty S, Lloyd K, Brownlee S, Farnham J., “A Midterm Assessment of the New Jersey DSRIP Program: Examining Implementation and Early Effects”, Poster Presentation, Academy Health Annual Research Meeting, Boston, 2016.
- Farnham, J., “Evaluation of Managed Long-Term Services and Supports (MLTSS).” Presentation to Good Care Collaborative, August 2015.
Reports for CMS
- A Summative Evaluation of the New Jersey DSRIP Program: Findings from Stakeholder Interviews, Hospital Surveys, Medicaid Claims Data, and Reported Quality Metrics (April 2018)
- Stakeholder Feedback on Implementation of the Managed Care Expansion in Long-Term Services and Supports (Second Round, June 2017)
- Examining the Effect of the NJ Comprehensive Waiver on Access to Care, Quality, and Cost of Care: Draft Final Evaluation Report (June 2017)
- Examining the Effect of the NJ Comprehensive Waiver on Access to Care, Quality, and Cost of Care: Draft Interim Evaluation Report (July 2016)
- A Midpoint Evaluation of the New Jersey DSRIP Program: Findings from Stakeholder Interviews, Hospital Survey, Medicaid Claims Data, and Reported Quality Metrics (September 2015)
- Initial Stakeholder Feedback on Implementation of the Managed Care Expansion in Long-Term Services and Supports (July 2015)
Federal and State Resources
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