Delivery System/Safety Net

January 5, 2017

This issue brief describes the key elements of the most recent MassHealth 1115 waiver extension, including the shift to a delivery system centered on Accountable Care Organizations and Community Partners, a Delivery System Reform Incentive Program, the redesigned Safety Net Care Pool, and the expansion of services for treatment of substance use disorders. It concludes with a discussion of implications of the new system for major stakeholder groups.

November 22, 2016

This chart pack provides updated MassHealth enrollment data as of September 2016.

July 26, 2016

This report includes findings from the evaluation of the 2015 Fostering Effective Integration grant program. The goals of the evaluation were to determine 1) how grantees defined “success” for their integration efforts, 2) grantee perceptions of the critical components of effective integration programs, 3) common barriers to integration, and 4) measures grantees used to assess programs.

Fostering Effective Integration of Behavioral Health and Primary Care in Massachusetts, Year One Report
July 21, 2016

In recent years, integrating treatment for mental health and substance use disorders (SUD) with primary care has been the subject of extensive research testing a number of different integration models and specific interventions. While many of these approaches have shown promise in demonstrations or clinical trials, the true test of value is in real-world settings where there are competing demands on scarce resources, strict fidelity to intervention protocols is difficult, and patients have multiple urgent needs.

June 16, 2016

UPDATED (June 2016) chart pack produced by the Massachusetts Medicaid Policy Institute (MMPI), a program of the Blue Cross Blue Shield of Massachusetts Foundation, in partnership with the Center for Health Law and Economics at the University of Massachusetts Medical School. This updated edition includes MassHealth enrollment as of January 2016 and spending from state fiscal year 2015 and is made available in PDF and Power Point formats to facilitate its use in presentations.

May 19, 2016

International comparisons of industrialized countries show that those with a higher ratio of social service spending relative to health care spending have better health outcomes. This finding is consistent with decades of research underscoring the importance of social, behavioral, and environmental factors on health outcomes.

May 10, 2016

This report, prepared by Manatt Health, lays out a vision for MassHealth long-term services and supports (LTSS) that is person-centered, integrated, sustainable, accountable, and actionable, providing Massachusetts policymakers with a set of options to consider when tackling some of the most intractable challenges facing the Commonwealth’s LTSS system.

April 12, 2016

Chapter 58 of the Acts of 2006—“An Act Providing Access To Affordable, Quality, Accountable Health Care”—was signed into law by Governor Mitt Romney on April 12, 2006. The groundbreaking law sought near-universal health care coverage for the residents of Massachusetts by expanding Medicaid, creating a new program of subsidized insurance, enacting changes to the health insurance market, and requiring adults to have health insurance unless an affordable option was not available.

March 23, 2016

This collection of reports and chart packs is the latest in a series by the Urban Institute analyzing the results of the Massachusetts Health Reform Survey (MHRS) which has been conducted most years since 2006, the year that Commonwealth enacted comprehensive health care reform.

March 8, 2016

This report, prepared by Robert Belfort and Alex Dworkowitz of Manatt, Phelps & Phillips, LLP, provides a review of the primary Massachusetts and federal privacy laws relevant to the exchange of information among physical and behavioral health providers and an assessment of technological and operational challenges faced by providers seeking to integrate care through enhanced data exchange.

February 18, 2016

Although Massachusetts has successfully achieved the lowest rate of uninsurance in the nation, thousands of individuals and families still live with the potential adverse health effects and financial impacts of not having health insurance. In 2015, an estimated 200,000 individuals in Massachusetts did not have health insurance coverage.

December 2, 2015

This chart pack, prepared by Manatt Health Solutions, provides an examination of the current state of long-term services and supports (LTSS), an area identified as a priority for reform by MassHealth (Massachusetts Medicaid). MassHealth accounts for nearly half of all spending on LTSS, amounting to $4.5 billion annually, and equal to 12 percent of the state budget. Using previously unpublished LTSS data, the chart pack examines MassHealth LTSS spending and utilization, access and affordability, workforce capacity and quality.

October 20, 2015

This primer, prepared by Ellen Breslin of Health Management Associates, includes an explanation of how state Medicaid programs generally pay their MCOs, the overall process for setting Medicaid managed care capitation rates and the various tools that states use to mitigate the risks that MCOs face when they assume financial responsibility for Medicaid members.

August 20, 2015

In March 2010, President Obama signed The Patient Protection and Affordable Care Act (ACA), which included significant changes impacting health insurance coverage across the United States. Although many elements of the ACA were based on Massachusetts’ health insurance reform, there were still many decisions and activities that Massachusetts needed to address in order to comply with the new federal Medicaid and health insurance marketplace requirements, most of which were required to be effective as of January 2014.

August 5, 2015

The “Making Health Care Affordable” (MHCA) three-year grant program concluded in 2014. Margaret Houy and Kate Bazinsky of Bailit Health Purchasing, LLC report on the impact of the BCBSMA Foundation’s funding initiative. The goal of MHCA was to fund interventions aimed at containing costs while increasing access and quality of care. Bailit examines how the Foundation’s objectives were met, what factors led to successful program implementation, common barriers faced by grantees, and which programs may have generalizability.

July 30, 2015
Medicaid, a federal-state partnership program, has advanced a variety of both federal and state health coverage reform goals over the last 50 years. There is perhaps no state in which Medicaid has played a more important role in the evolution of how health care is delivered and paid for than Massachusetts. This interactive timeline reflects some of the key moments in our history where Medicaid served to expand coverage for low-income and vulnerable people in the Commonwealth.
June 29, 2015

Social determinants of health, which encompass social, behavioral and environmental influences on one’s health, have taken center stage in recent health policy discussions. While research indicates that greater attention to these non-medical factors may improve health outcomes and reduce health care costs, translating this evidence into actionable recommendations for policy makers and others has been challenging.

June 23, 2015

This report, prepared by Sharon Long and Thomas Dimmock of the Urban Institute, further analyzes the 2013 Massachusetts Health Reform Survey (MHRS) by comparing the experience of adults with public coverage to adults with employer-sponsored insurance (ESI) coverage across a number of access and affordability measures. Findings from the analysis show problems with access to care were more prevalent for adults with public coverage than for those with ESI.