Evaluating Oregon Health Authority’s ARPA Spending on HCBS Programs
Problem
Oregon sought rigorous evaluation to measure ARPA-driven progress in enhancing Medicaid home- and community-based services for beneficiaries.
The American Rescue Plan Act of 2021 (ARPA) was enacted to support economic recovery and public health improvements in response to the COVID-19 pandemic. ARPA Section 9817 temporarily increased the federal medical assistance percentage (FMAP) for Medicaid home- and community-based services (HCBS), providing states with enhanced funding to strengthen these services.
Through the March 31, 2025, spending deadline, the Oregon Health Authority (OHA) and Oregon Department of Human Services (ODHS) invested ARPA funds in initiatives across an array of investment categories, including but not limited to provider benefits, infrastructure, consumer benefits, and workforce. These investments were part of Oregon’s broader strategy to improve service delivery and better support Medicaid beneficiaries in community settings. As the funding period nears its end, OHA seeks to evaluate the effectiveness of ARPA-funded HCBS projects across both agencies, specifically whether the initiatives achieved their intended goals and how successfully the funds were allocated and used.
Solution
NORC is using primary and secondary data to evaluate the impact of ARPA investments on Medicaid HCBS in Oregon.
NORC is conducting a comprehensive mixed-methods evaluation of Oregon’s use of ARPA funds to enhance Medicaid HCBS. This evaluation focuses on several areas, including:
Access to and quality of HCBS
Alignment of program goals and objectives within each investment category
Stakeholder perspectives and satisfaction
Lessons learned from the distribution and implementation of ARPA funding
To support this work, NORC is collecting and analyzing data. Primary data sources include formative interviews with OHA and ODHS; a workforce survey focused on HCBS workforce retention and training; and focus groups with a subset of surveyed health care workers to gather deeper qualitative insights.
Secondary data sources include Oregon’s Medicaid enrollment, claims, and encounter data; program documentation; case management records; and relevant data and documentation from state and federal agency agencies. Together, these data sources will inform a robust, evidence-based assessment of how ARPA investments have shaped Oregon’s HCBS landscape and identify opportunities for future improvement and sustainability.
Result
Our work will generate insights to strengthen Oregon’s HCBS program and guide the strategic allocation of future funding.
The evaluation began in 2024. To date, NORC has developed an Evaluation Design Plan outlining our approach, aligned with OHA’s research objectives. In 2025, we produced an Interim Evaluation Report detailing progress across evaluation domains, including some preliminary descriptive findings from secondary data sources. A final summative evaluation report will be completed in 2026. Findings will be shared with Oregon policymakers and other key stakeholders to inform future decision-making.
Throughout the contract period, NORC is collaborating with OHA and ODHS to develop evaluation tools and contribute to key project deliverables. This includes developing evaluation instruments that reflect agency priorities and ensure meaningful stakeholder input. The evaluation findings will help guide future investments and inform recommendations to strengthen Oregon’s HCBS program and improve service delivery for Medicaid beneficiaries across the state.
Related Tags
Project Leads
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Jennifer Smith
Principal Data ScientistProject Director -
Maeve Russell
Research ScientistProject Manager -
Karen Swietek
Principal Health EconomistEvaluation Lead -
Lisa R. Shugarman
Senior FellowSubject Matter Expert -
Nicole Clark
Senior Research DirectorSubject Matter Expert -
Laura Wagstaff
Senior Research DirectorQualitative Lead -
Rachel Carnahan
Senior Research Director ISurvey Lead
“ARPA gave Oregon a unique opportunity to strengthen home- and community-based services at scale. By combining qualitative interviews, surveys, and Medicaid data analysis, our team is uncovering practical ways to make HCBS stronger. We’re already seeing where improvements are taking hold and how lessons learned can guide sustainable change.”
