This technical assistance tool summarizes federal authorities that states may find useful in restructuring Medicaid health care delivery or payment, and that can be exercised through State Plan Amendments or waivers. The tool uses a chart to highlight the flexibilities and limitations of the authorities found in various waivers.

This technical assistance brief is a product of the Integrated Care Resource Center made possible by the Centers for Medicare & Medicaid Services. The Integrated Care Resource Center is a national initiative to help states improve the quality and cost-effectiveness of care for Medicaid’s high-need, high-cost beneficiaries. The state technical assistance activities provided within the Integrated Care Resource Center are coordinated by Mathematica Policy Research and the Center for Health Care Strategies.