Reports by the National Academy of State Health Policy and the Medicaid and CHIP Payment and Access Commission point to new trends, including increased focus on reform, new financing mechanisms, and standardized evaluation.

The waiver extensions fund Texas' uncompensated care pool and delivery system reform incentive payment program and provide family planning services for low-income individuals in Mississippi for 10 years.

A new policy brief by America's Essential Hospitals notes that managed care pathways might be a potential complement, or alternative, to waiver-based delivery system reform.

Proposed renewals must be for demonstrations that are working effectively and have no major or complex policy changes. Certain waivers that use the enhanced FMAP are ineligible.

MACPAC's report to Congress touts potential of DSRIP programs to transform Medicaid reimbursement and improve health outcomes, also addresses the challenge and calls for clear and consistent federal guidance.