Reports
The Medicaid Transformation Project (MTP) is Washington state's Section 1115 Medicaid demonstration waiver. MTP is an agreement between the Health Care Authority (HCA) and the Centers for Medicare & Medicaid Services (CMS) that allows our state to develop innovative programs and services that improve Washington’s health care system using approved, federal Medicaid dollars. HCA tracks and measures the progress and impact of MTP through various reporting requirements. This page provides links to MTP's quarterly and annual reports that we submit to CMS.
MTP 1.0
In January 2017, our state began MTP, a five-year Section 1115 Medicaid demonstration waiver. This initial waiver — also called MTP 1.0 — was scheduled to end December 31, 2021. However, CMS approved our request to extend MTP for an additional year because of the COVID-19 public health emergency. MTP 1.0 was then scheduled to end December 31, 2022. CMS also granted an extension of the initial MTP waiver while we negotiated on a renewal. The end of the initial MTP waiver was June 30, 2023.
Past reports and documents related to Washington's Section 1115 Medicaid demonstration waiver can be found on the CMS website.
- Summative Evaluation Report
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This report evaluates the state’s progress from January 2017 through December 2022, spanning MTP 1.0 demonstration years one through six. It was prepared for HCA by The Center for Health Systems Effectiveness at Oregon Health & Science University (OHSU). In this report, OHSU outlines the goals of Washington’s 1115 Medicaid demonstration wavier and describes evaluation activities, including evaluation hypotheses, data, and methods. HCA submitted this report to CMS as a final deliverable.
CMS approved Washington state’s MTP Summative Evaluation Final Report. CMS's review found through the application of a rigorous evaluation methodology, MTP demonstrated measurable progress in advancing integrated care, expanding access to housing and employment supports, and strengthening the state’s capacity for substance use disorder and behavioral health treatment.
- Medicaid Transformation Project Summative Evaluation Report approval letter (November 3, 2025)
MTP 2.0
On June 30, 2023, CMS approved Washington state's MTP renewal — called MTP 2.0 — to continue the work for an additional five years. MTP 2.0 began July 1, 2023 and will continue through June 30, 2028.
- Annual Monitoring Report
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In 2025, CMS revised Section 1115 Medicaid demonstration waiver reporting requirements from a quarterly basis to an annual basis. Due to Washington's reporting cycle, the MTP Annual Monitoring Report covers three reporting periods in Demonstration Year 9 in which Washington previously submitted Quarterly Progress Reports, plus quarter 4, which Washington did not submit a Quarterly Progress Report.
- MTP Annual Monitoring Report for Demonstration Year 9 (July 1, 2024–June 30, 2025)
- Quarterly Progress Reports
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Demonstration Year 9
- First reporting period (July–September 2024)
- Second reporting period (October–December 2024)
- Third reporting period (January–March 2025)
Demonstration Year 8
MTP 2.0 began July 1, 2023, which started Demonstration Year (DY) 8. Note: Due to Washington's reporting cycle, the below reports do not align with regular calendar quarters.
- First reporting period (July–September 2023)
- Second reporting period (October–December 2023)
- Third reporting period (January–March 2024)
- Fourth reporting period (April–June 2024)