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Teresa DeCaro

Deputy Director, State Demonstrations Group
Centers for Medicaid and CHIP Services (CMCS)
Centers for Medicare & Medicaid Services

Teresa DeCaro is currently the Deputy Director of the State Demonstration Group (SDG) in the Center for Medicaid and CHIP Services (CMCS), in the Centers for Medicare & Medicaid Services (CMS), where she is responsible for Medicaid 1115 demonstration operations, monitoring and evaluation. Previously she was a Senior Advisor to the Director of CMCS primarily focused on the development and evaluation of Medicaid payment and delivery service reform demonstrations, and was CMCS liaison to the Center for Medicare and Medicaid Innovation (CMMI), facilitating coordination between these centers on policy and operational issues that affect innovation in the Medicaid program.

Teresa has broad experience in health policy and operations, and has led a variety of program start-ups in CMS. She was the Acting Director of the Exchange Policy and Operations Group in the Center for Consumer Information and Insurance (CCIIO), where her principal areas of responsibility under the Affordable Care Act (ACA) were Marketplace eligibility and enrollment, issuer and health plan certification, and quality reporting and monitoring. Previously, she was the Acting Director of the Medicare Part C group responsible for health plan benefits and rate approvals, and for issuer and plan management policy. She also led the division that designed and stood up Medicare Part D plan reviews and oversight; and the policy and implementation of the first means tested benefits in Medicare, under the Medicare drug discount card program.

Teresa has long had an interest in service delivery and how to improve it. For example she led the policy development, launch and early refinements of Special Needs Plans for people dually eligible for Medicare and Medicaid. Teresa’s earliest work in CMS focused on research and demonstrations to create financial and other incentives for fee-for-service providers to integrate and improve the quality and efficiency of service delivery to Medicare beneficiaries. A number of her early projects are precursors to programs under ACA, including Accountable Care Organizations and shared savings arrangements. Teresa’s first career was in adult critical care nursing, and her graduate work focused on economic and social support levers to improve the quality of life for people with chronic and severe illness.