How Section 1115 Waivers Became Central to State Medicaid Strategy—and What's Next

The piece examines how Medicaid 1115 waivers evolved over the past decade from narrow pilots to comprehensive program frameworks encompassing managed care, behavioral health integration, and LTSS redesign. It reviews what worked—particularly improved access to SUD treatment and mental health services—while noting the administrative complexity, budget neutrality pressures, and increased federal scrutiny states now face. The analysis is directly relevant to MCO executives and state Medicaid officials navigating waiver renewals, expansions, and changing federal policy.

Managed Care · Behavioral Health · LTSS · Finance

This is outside commentary from Sellers Dorsey, not part of Medicaid Monitor's independently scored news coverage.

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