The Centers for Medicare and Medicaid Services (CMS) has invited states to request authority to make employment a condition of Medicaid eligibility. CMS was also given by Congress the ability to give states more freedom to test and evaluate approaches to improving program quality, accessibility, and health outcomes in the most cost-effective manner. Guidance was issued earlier this year that provide detailed instructions on how to evaluate the new work requirements with metrics and reporting standards related to employment.
States planning to implement this initiative have many details to consider. The new work requirements will result in additional responsibilities and increased administrative costs for states. At the same time, the administrative costs may be eligible for federal matching funds ranging from 50% to 90%.
This paper highlights several aspects of executing a “work requirement/community engagement” program that should be considered prior to putting it into effect.