Determining the Impact of State Demonstrations: Considerations for State and Federal Policymakers

States and the federal government are investing heavily in state demonstrations to reform the health care delivery system, and gauging the impact of these demonstrations through monitoring and evaluation requires time and effort from both state and federal officials. Greater alignment between state and federal evaluation and monitoring activities and across programs could streamline reporting requirements, ease administrative burden, and improve the effectiveness and efficiency of monitoring and evaluation. In June 2015, the National Academy for State Health Policy convened state and federal leaders to identify actionable steps toward a shared federal and state agenda on improving the monitoring and evaluation of state demonstrations. This brief reflects on the convening’s discussion.