The Centers for Medicare and Medicaid (CMS) approved a September 2025 independent evaluation on the State of Massachusetts' 1115 Demonstration Waiver. Overall, the report finds that the Demonstration saved the Commonwealth more than $500 million over five years, and that the state has the lowest uninsurance rate among comparison states. 

 

However, some excerpts from the report highlight the advocacy work to be done. Some ACOs interviewed mentioned that home health was seen as a cost-driver and a 'tremendous expense' (page143). Though these were in reference to the pandemic-era increases in home health utilization - it illustrates the lack of acknowledgement the role our industry played during the pandemic in keeping people home.