Demonstration Projects and Evaluation Reports

Demonstration Projects:

CMS conducts and sponsors a number of innovative demonstration projects to test and measure the effect of potential program changes. Our demonstrations study the likely impact of new methods of service delivery, coverage of new types of service, and new payment approaches on beneficiaries, providers, health plans, states, and the Medicare Trust Funds. Evaluation projects validate our research and demonstration findings and help us monitor the effectiveness of Medicare, Medicaid, and the State Children's Health Insurance Program (SCHIP).

Future Demonstrations

• Update on Upcoming Demonstrations under Medicare Modernization Act (MMA) - see this link for listings of upcoming demonstration projects.
• Cancer Prevention and Treatment Demonstration - This demonstration evaluates projects for targeted ethnic and racial minorities.
• The Medicare Replacement Drug Demonstration - This demonstration, currently under development, involves the certain prescription and biologicals program.
• Demonstration Project For Competitive Bidding Of Clinical Laboratory Services - This demonstration, currently under development, examines opportunities for bidding for certain clinical laboratory services under Medicare.
• Senior Risk Reduction Program Demonstration
  
- CMS is developing the Senior Risk Reduction Program to test a comprehensive and systematic approach to identifying health risks and empowering Medicare beneficiaries to improve their health.

Solicitations Period Closed/Ongoing Demonstrations - We are no longer taking applications; they are in various stages of implementation.

• Demonstrations Serving Those Dually - Eligible for Medicare and Medicare - This demonstration involves the dual eligibles program.


• ESRD Disease Management Demonstration - The End-Stage Renal Disease (ESRD) Disease Management Demonstration will increase the opportunity for Medicare beneficiaries with ESRD to join integrated care management systems. The demonstration is designed to test the effectiveness of disease management models to increase quality of care for ESRD patients while ensuring that this care is provided more effectively and efficiently.
• Home Health Independence Demonstration - This demonstration is a 2-year demonstration mandated under Section 702 of the MMA for Medicare beneficiaries in Colorado, Massachusetts, and Missouri. The purpose of the demonstration is to study the benefits and cost of allowing Medicare beneficiaries with severe, chronic conditions to be deemed homebound for the purposes of remaining eligible for Medicare home health services even though they leave home more than would be allowed under the usual Medicare rules.
• Medicare BIPA Disease Management Demonstration - This demonstration began enrolling beneficiaries in February 2004.
• Medicare Capitated Disease Management Demonstration - This demonstration is geared to health plans and other entities that want to market disease management services to chronically ill Medicare beneficiaries for an all-inclusive capitated payment.
• Medicare Coordinated Care Demonstration - This demonstration is operational in 15 sites.
• Medicare Lifestyle Modification Program Demonstration - This demonstration involves the lifestyle modification program.
• Medicare Physician Group Practice Demonstration - Applications were due December 26, 2002, and are currently under review.
• Medicare Preferred Provider Organization Demonstration - This demonstration began enrolling beneficiaries in January 2003.
• Medicare Stop Smoking Program Demonstration - This demonstration involves the stop smoking program.
• Premier Hospital Quality Incentive Demonstration - This demonstration will recognize and provide financial rewards to hospitals that demonstrate high quality performance in a number of areas of acute care.

Medicaid Demonstration Information
Click above for information on state waiver and demonstration programs.

Additional Demonstrations – Active Projects Database

We have summaries of additional demonstration projects in our Active Projects Report: Research and Demonstrations in Health Care Financing (APR). The APR is an annual publication that inventories both intramural projects conducted by CMS staff and extramural projects conducted, with CMS support, by contractors, grantees, and other awardees. The APR presents a brief description of each project, including its identification number, project title, awardee, funding, and the period of performance. The current edition of the APR can be accessed here.

Evaluations of Demonstration Projects:

Medicaid State Reform Demonstrations

• Five-State Medicaid Reform Evaluation
• Oregon State Reform Evaluation

Medicare Demonstrations

Analysis of Medicare Beneficiary Knowledge Data - (Feb. 2003)

CABG Centers of Excellence Demonstration - (Sept. 1998)

Community Nursing Organization Demonstration - (Jan. 2003)

DoD Subvention Demonstration - (Feb. 2004)

Durable Medical Equipment Competitive Bidding Demonstration - (Sept. 2002)

"Early" Coordinated Care Demonstration - (1995)

End-Stage Renal Disease Managed Care Demonstration - (2002)

Evaluation of the QMB and SLMB Programs - (Sept. 2003)

Evercare Demonstration - (August 2002)

Home Health Agency Prospective Payment Demonstration - (April 2001)

Medicare Choices Demonstration - (1997)

PACE Demonstration - (1998)

Partnership for Quality Services Demonstration - (2002)

Social Health Maintenance Organization - (2002)