Long term services and supports (LTSS) are the critical services and supports that people with disabilities and chronic conditions of all ages use to meet their daily living needs, remain independent, and participate in their communities. This primer provides a thorough landscape assessment of LTSS in Massachusetts and serves as a follow-up to the Foundation’s December 2022 report, A Focus on Health Care: Five Key Priorities for the Next Administration, which identified improving access to LTSS as one of five key areas requiring immediate and focused action in Massachusetts.  

This primer is intended to help stakeholders better understand LTSS in Massachusetts: what these services are, who uses them, and how they are delivered and paid for. In summarizing the available data on LTSS payers and programs, utilization and spending, workforce capacity, and quality, the primer highlights the strengths and the challenges in LTSS delivery and access in Massachusetts today.  It also identifies opportunities and considerations for improving access to and quality of LTSS in Massachusetts.

The Blue Cross Blue Shield of Massachusetts Foundation today announced that thirteen health and science journalists from across the nation have been selected for the 2024 class of the Health Coverage Fellowship.

The Blue Cross Blue Shield of Massachusetts Foundation today announced that thirteen health and science journalists from across the nation have been selected for the 2024 class of the Health Coverage Fellowship.

The 2024 fellows are Olivia Aldridge of KUT in Austin, Emily Bader of the Maine Monitor, Amanda Beland of Boston’s WBUR, Fred Clasen-Kelly of KFF Health News, Katy Golvala of the Connecticut Mirror, Brenda Goodman of CNN, Alex Janin of the Wall Street Journal, Katie Jennings of Forbes, Sydney Lupkin of NPR, Sabrina Malhi of the Washington Post, Sophia Paffenroth of Mississippi Today, Annmarie Timmins of the New Hampshire Bulletin, and Brittany Trang of STAT.

The fellowship is designed to help the media improve its coverage of critical health care issues. It does that by bringing in as speakers more than 75 health officials, practitioners, researchers, and patients. It also brings the journalists out to watch first-hand how the system works, from walking the streets at night with mental health case workers to visiting labs that make stem cells and vaccines.

The program, which is entering its twenty-third year, is sponsored by the Blue Cross Blue Shield of Massachusetts Foundation, with support from the Bower Foundation in Mississippi, Connecticut Health Foundation, Endowment for Health in New Hampshire, Fledgling Fund, KFF, Maine Health Access Foundation, National Institute for Health Care Management Foundation, Rita Allen Foundation, Robert Wood Johnson Foundation, and, in Texas, the Episcopal Health Foundation, Congregational Collective at the H.E. Butt Foundation, Methodist Healthcare Ministries, and St. David’s Foundation.

The fellowship will run for nine days, beginning September 6, 2024. It is housed at Babson College’s Executive Conference Center in Wellesley, MA. Larry Tye, who covered health and environmental issues at the Boston Globe for 15 years, directs the program. A former Nieman Fellow and author of nine books, Tye has taught journalism at Boston University, Northeastern, Tufts, and Harvard.

Next fall’s fellowship will focus on a series of pressing issues – from preventing future pandemics to treating mental illness, rooting out racial and ethnic inequities, redressing homelessness, and rethinking later-life care. Attention also will be given to breakthroughs in medical treatments and curbing health-care costs.

The teaching will not end when fellows head back to their outlets. Tye, the program director, will be on call for the journalists for the full year following their nine days in Wellesley. He will help when they are stuck for ideas or whom to call on a story. He also will assist in thinking out projects and carving out clearer definitions of beats.

About the Blue Cross Blue Shield of Massachusetts Foundation

The mission of the Blue Cross Blue Shield of Massachusetts Foundation is to ensure equitable access to health care for all those in the Commonwealth who are economically, racially, culturally or socially marginalized.  The Foundation was established in 2001 with an initial endowment from Blue Cross Blue Shield of Massachusetts.  It operates separately from the company and is governed by its own Board of Directors.  More information is available at www.bluecrossmafoundation.org.

The Blue Cross Blue Shield of Massachusetts Foundation, a nonprofit grantmaking and research organization, has released a report that analyzes how MassHealth’s estate recovery policies affect members and, upon their death, their surviving families, particularly in marginalized communities.  The Foundation offers additional reforms that could help reduce negative impacts, such as requiring the sale of a family home.

The Blue Cross Blue Shield of Massachusetts Foundation, a nonprofit grantmaking and research organization, has released a report that analyzes how MassHealth’s estate recovery policies affect members and, upon their death, their surviving families, particularly in marginalized communities.  The Foundation offers additional reforms that could help reduce negative impacts, such as requiring the sale of a family home.

The report, titled “Holding on to Home: A Primer on MassHealth Estate Recovery and Options for Reducing its Impact on Members and Families,” was commissioned by the Massachusetts Medicaid Policy Institute, a program of the Foundation, and produced by Aurrera Health Group.

Federal law requires states to recoup costs from certain Medicaid members’ estates – the money and possessions left after someone dies – if they received long-term services and supports (LTSS), such as care in a nursing facility or at home.  But some states, including Massachusetts, exceed the federal minimum and recover the cost of all Medicaid-covered services that are provided to members over age 55.  This means far more members are affected because it is not just limited to those who use LTSS.

MassHealth instituted reforms in 2021 that created additional hardship waivers available to families and reduced the number of estates subject to recovery, lowering its gross collections to an estimated $23 million.  Prior to these reforms, Massachusetts recovered more from member estates than any other state, prompting criticism that the policy was having an outsized burden on low-income families.  Critics of the current policy argue that estate recovery can reinforce cycles of poverty and prevent families from creating generational wealth, since the process often forces the sale of the deceased member’s home to pay off the Medicaid-related debt.

“Our analysis provides a deeper understanding of how the estate recovery process has the potential to perpetuate wealth disparities and intergenerational poverty,” said Audrey Shelto, President and CEO of the Blue Cross Blue Shield of Massachusetts Foundation.  “Massachusetts now has the opportunity to consider aditional reforms that will help reduce disparities and financial distress for families.”

The report outlines several options for further reform of MassHealth’s estate recovery program, including:

• Prohibiting estate recovery for non-mandatory services for individuals age 55 and over, meaning the state would only seek to recover LTSS-related costs and not those for services that the federal government does not require to be included in estate recovery.  This option would require legislative action.
• Establishing additional hardship criteria, such as exempting homes of modest value or assets that are the sole income-producing asset of a family.
• Waiving the first $25,000 in value of any estate subject to a recovery claim.
• Providing information on MassHealth’s estate recovery program in multiple languages, which would enhance education and accessibility.
• Educating advisors who help individuals enroll in MassHealth about estate recovery to improve understanding of the program and the availability of hardship waiver options.
• Publishing an annual report on the impacts of the estate recovery program, including data on hardship waivers.

This would build on the reforms that MassHealth has already made while providing additional relief for members, families and marginalized communities.  Accompanying the report is a set of profiles of Massachusetts residents who were negatively impacted by the estate recovery process.

“As these stories demonstrate, the emotional and financial consequences for the low-income families facing MassHealth estate recovery can be devastating,” said Katherine Howitt, Director of the Massachusetts Medicaid Policy Institute.  “While MassHealth recently reformed its estate recovery program to reduce the impact on its members, there is more that Massachusetts can do to limit the harm from this policy.”

The report is available online at the following link: https://www.bluecrossmafoundation.org/publication/holding-home-masshealth-estate-recovery

About the Blue Cross Blue Shield of Massachusetts Foundation

The mission of the Blue Cross Blue Shield of Massachusetts Foundation is to ensure equitable access to health care for all those in the Commonwealth who are economically, racially, culturally or socially marginalized.  The Foundation was established in 2001 with an initial endowment from Blue Cross Blue Shield of Massachusetts.  It operates separately from the company and is governed by its own Board of Directors.  For more information, visit www.bluecrossmafoundation.org.

Federal law requires states to recoup costs from certain Medicaid members’ estates – the money and possessions left after someone dies – if they received long-term services and supports (LTSS), such as care in a nursing facility or at home. But some states, including Massachusetts, exceed the federal minimum and recover the cost of all Medicaid-covered services that are provided to members over age 55. This means far more members are affected because it is not just limited to those who use LTSS. By limiting the passing down of assets – including homes – the practice of estate recovery may perpetuate wealth disparities and intergenerational poverty. While MassHealth has made reforms in recent years to reduce the burden of estate recovery on impacted members and families, more can be done.

These materials are intended to educate stakeholders, policymakers, and others about MassHealth’s estate recovery program. They include:

• An issue brief that describes Massachusetts’ estate recovery policy and practices and what is known about its impact on members and their families. The brief also identifies policy and programmatic options that the state could pursue to reduce the burden of estate recovery.
• A series of qualitative profiles that tell the stories of how estate recovery has impacted four individuals in Massachusetts after the loss of a loved one.

The Blue Cross Blue Shield of Massachusetts Foundation, a nonprofit grantmaking and research organization, today announced nearly $1.8 million in grants as it expands investments in two key grant programs focused on racial justice in health and community-based mental health.  Since it was established in 2001, the Foundation has granted more than $84 million.

The Blue Cross Blue Shield of Massachusetts Foundation, a nonprofit grantmaking and research organization, today announced nearly $1.8 million in grants as it expands investments in two key grant programs focused on racial justice in health and community-based mental health.  Since it was established in 2001, the Foundation has granted more than $84 million.

“The Foundation is making these vital funding commitments to improve the health care experience for communities of color and increase access to community-based mental health services, two areas of great concern,” said Audrey Shelto, President and CEO of the Blue Cross Blue Shield of Massachusetts Foundation.  “Our grant partners have made significant strides since initial funding support and we look forward to successful outcomes in 2024 and beyond.”

Racial Justice in Health grants

The Foundation expanded its Racial Justice in Health program to a third funding year, enabling grant partners to continue building their capacity and expertise in health care advocacy as they aim to advance policies and practices that promote racial justice and equity in health care delivery.  The following organizations led by people of color will receive $72,250 each for their respective initiatives:

• Asian Women for Health, a peer-led, statewide network based in Somerville dedicated to advancing the health and well-being of Asian women, including cancer survivors and immigrants, through education, advocacy and support. AWFH will work on implementation of the recently passed state Data Equity Law as well as work to improve language access and inclusion in health policies.
• Brookview House, a Black and Latinx woman-led nonprofit organization in Dorchester that provides support services and programs that confront the root causes of homelessness and poverty for mothers who are low-income and works for justice, equity and systemic change for families with low-income.  Brookview will work with young people and focus on the intersection of substance use disorders and oral health.
• GreenRoots, an organization that bridges environmental justice and public health by engaging the most impacted residents in the highly industrial neighborhoods of Chelsea and East Boston.  GreenRoots will continue to work on policies to improve air quality and other environmental health issues that impact the health and health outcomes in their communities.
• La Colaborativa, which empowers Latinx immigrants in the Chelsea area to enhance the social and economic health of the community and to hold institutional decision-makers accountable to the community.  La Colaborativa will work on health care enrollment and efforts to expand access to health care for immigrants.
• Somali Development Center, a Roxbury-based nonprofit providing educational and social services to refugees and immigrants in Greater Boston who are primarily from Somalia, Ethiopia, Eritrea, Sudan and Djibouti.  The center will work on efforts to improve oral health care and increase health care access for newly arrived refugees and immigrants.
• The Welcome Project, a Somerville-based nonprofit organization that builds the collective power of immigrants to shape and participate in community decisions through programming for youth and adults and families.  The Welcome Project will work to advance efforts for equitable, healthy and safe working conditions for immigrant workers as a means to improve community health.

“We are continuing our Racial Justice in Health grants for a third year to further our vision for a more diverse and effective health advocacy movement that incorporates the voices of those who experience inequity every day,” said Jacquie Anderson, the Foundation’s Senior Director of Grantmaking.

Advancing Community-Driven Mental Health grants

The Foundation also awarded a second round of grants through its Advancing Community-Driven Mental Health program to five nonprofit organizations that are training non-clinical staff to offer support to clients experiencing mild to moderate mental health distress and problems of everyday living.  The following organizations received $150,000 each to continue their projects to improve access to community-based mental health services and expand the behavioral health workforce:

• Boston Senior Home Care, which is working to improve access to community-based mental health services through a supportive housing program, Supporting Connections, in Boston’s Dorchester neighborhood, including training tenant service coordinators.
• Cambridge Economic Opportunity Committee, whose Journey to Hope program focuses on underserved individuals including low-wage earners, those with limited English-language proficiency, people with disabilities, seniors and residents of subsidized housing.
• Quincy Asian Resources Inc., whose Life Balance program is training its family and community services coordinators to support the mental health challenges of clients who have an immigrant background, typically speak Chinese or Vietnamese, and have experienced acculturation stress.
• Stavros Center for Independent Living, which is implementing the Project Management Plus (PM+) model with a program called Take Charge to support people living with disabilities in western Massachusetts who have difficulty getting mental health services due to limited access to the internet and transportation.
• The Community Builders Inc., whose Village Connections program is focusing on individuals with low incomes and often in need of mental health care who live in family-designated affordable housing in Boston, Mashpee and Worcester.

In addition, the Foundation is providing a total of $270,161 to two technical assistance partners, The Family Van and Partners In Health, for the development and implementation of the Advancing Community-Driven Mental Health grant program.

Special Initiatives grants

The Foundation also continued to provide one-time grants through its Special Initiatives program, which is for organizations to pilot or launch a new project that empowers communities to advance health equity.  The Foundation is providing a total of $300,000 to six nonprofit organizations that are working to improve health care access across Massachusetts.

• Girls Inc. of the Valley, for a project that will advance health care access and health equity by creating new low-barrier, no-cost mental health services for BIPOC youth from low-income families, integrated within the Holyoke-based organization’s programs.
• Northeast Arc, to support a statewide telehealth service, StationMD, that will increase health care access and improve outcomes for people with intellectual and developmental disabilities served by the Danvers-based organization and other human service agencies.
• Saheli Inc., a Burlington-based nonprofit that will create a cultural competency training program to increase the capacity of frontline hospital staff to recognize domestic and family violence occurring in the South Asian and Arab communities, a growing population in Massachusetts.
• UMass Amherst, for a community collaboration between the university’s Elaine Marieb College of Nursing and the Bay Area Neighborhood Council, that will address racial disparities in maternal health by bringing health education and resources to the majority Black and Hispanic Bay neighborhood in Springfield.
• Vital CxNs, to support a pilot project that will convene health providers, city government and residents who will create a roadmap for diabetes and cardiovascular disease prevention efforts, focused on communities of color in Boston’s Dorchester and Roxbury neighborhoods.
• Worcester RISE, for a project that will provide cross-cultural and trauma-informed training for behavioral health providers to better serve new migrant arrivals, including education on psychological first aid and mentorship programs for community health staff, resettlement case managers and outreach workers.

About the Blue Cross Blue Shield of Massachusetts Foundation

The mission of the Blue Cross Blue Shield of Massachusetts Foundation is to ensure equitable access to health care for all those in the Commonwealth who are economically, racially, culturally or socially marginalized.  The Foundation was established in 2001 with an initial endowment from Blue Cross Blue Shield of Massachusetts.  It operates separately from the company and is governed by its own Board of Directors.  For more information, visit www.bluecrossmafoundation.org.

MassHealth provides health care services to over 2 million Massachusetts residents. This updated infographic highlights key facts about MassHealth, including the many ways in which the program contributes to the Massachusetts economy and promotes health care coverage and access for residents in the state.

Peer supports are an important component of the health care system in Massachusetts. Peers provide a vital bridge to services by offering empathy, information, encouragement, and navigational assistance to people who face linguistic and cultural access barriers, stigma, absence of a support network, and other challenges. Peers are part of the communities they serve and often share lived experiences with the individuals they work with, making them uniquely qualified to foster trust in the health care system where it might be lacking. The nature of peers’ work is often well known in their own professional and programmatic circles, but understanding of their role is less clear across the broader health care system. This brief provides an overview of the primary professions that comprise the peer workforce in Massachusetts, where they work, and the various approaches to training, certification, and payment of these providers.

The Blue Cross Blue Shield of Massachusetts Foundation, a nonprofit grantmaking and research organization, today released a report that outlines a cohesive framework and proposed action plan for achieving a racially and ethnically equitable health care delivery system across Massachusetts.

The Blue Cross Blue Shield of Massachusetts Foundation, a nonprofit grantmaking and research organization, today released a report that outlines a cohesive framework and proposed action plan for achieving a racially and ethnically equitable health care delivery system across Massachusetts.

The report, produced with the Foundation’s research partner, Manatt Health, features a Health Equity Action Plan and companion toolkit that outline a vision, organizing structure and set of practical steps that health care delivery system leaders and other stakeholders can implement both now and in the future.  The overall vision, formed through the plan’s extensive research process, is for all people in Massachusetts to experience high-quality, accessible and timely care from providers who understand and respect their culture.

“Many health care organizations across the Commonwealth are actively focused on addressing racism and reducing health disparities and doing very good work.  We need to leverage these varied and often siloed efforts in a more cohesive way in order to create change of greater magnitude,” said Audrey Shelto, President and CEO of the Blue Cross Blue Shield of Massachusetts Foundation.  “It’s imperative that we coordinate our efforts so that we can make substantial and definitive progress toward an equitable health care system in Massachusetts.”

The Foundation presented the report during an event today with a panel of experts who discussed how the Health Equity Action Plan can be launched in Massachusetts – where health disparities among people of color can result in an economic burden of an estimated $5.9 billion each year due to avoidable spending, lost productivity and premature death.

The report outlines several “fast-start” actions in the first year to lay the groundwork, and includes examples such as identifying strategies to include consumers and communities in planning and activities; and building a shared inventory of best practices.  The report also calls for a permanent organizing entity to serve as a “home” that documents implementation and collaboration statewide, and the deployment of “action labs” in areas such as clinical care, payment models, provider access standards, and workforce strategies, among others, all designed to strengthen equity.

Following the event, the Foundation intends to move forward with a formal launch of the Health Equity Action Plan which will include a collaboration with the Health Equity Compact, a coalition of over 80 leaders of color in health care, public health, labor, business, academia, life sciences and philanthropy united in advancing health equity in Massachusetts.

“Building on our health equity movement – from the hallways of community health centers to the corridors of power on Beacon Hill – we must take actionable steps toward health care delivery reform in order to address health disparities and create a healthier Commonwealth,” said Rosa Colon-Kolacko, president and founder of Global Equity Learning and member of the Health Equity Compact’s leadership team.  “Statewide, systemic change requires the kind of collective effort outlined in the Health Equity Action Plan.  We look forward to collaborating with the Blue Cross Blue Shield of Massachusetts Foundation and other partners committed to driving transformational change for health equity in the health care delivery system and beyond.”

The Foundation anticipates that the proposed Health Equity Action Plan will evolve as part of a collaborative, co-designed process and be informed by progress, community voices, lessons learned and the emergence of new priorities and strategies.

“Our approach serves as a concrete proposal to launch systematic and coordinated action,” Shelto said.  “We expect this work to be challenging, as all important endeavors are, and our progress will truly accelerate when we all start working together with a shared vision and common goal.”

The Foundation’s report, titled Achieving a Racially and Ethnically Equitable Health Care Delivery System in Massachusetts: A Vision and Proposed Action Plan, is available online via the following link:

https://www.bluecrossmafoundation.org/publication/achieving-racially-and-ethnically-equitable-health-care-delivery-system-massachusetts

About the Blue Cross Blue Shield of Massachusetts Foundation

The mission of the Blue Cross Blue Shield of Massachusetts Foundation is to ensure equitable access to health care for all those in the Commonwealth who are economically, racially, culturally or socially marginalized.  The Foundation was established in 2001 with an initial endowment from Blue Cross Blue Shield of Massachusetts.  It operates separately from the company and is governed by its own Board of Directors.  For more information, visit www.bluecrossmafoundation.org.

This report proposes a statewide Health Equity Action Plan that offers an organizing structure, process, and set of practical steps for collectively achieving a racially and ethnically equitable health care delivery system in Massachusetts. The Health Equity Action Plan is accompanied by a toolkit, which includes an illustrative set of interventions and best practices that providers, health care delivery system leaders, and other stakeholders can deploy to achieve the envisioned system.

The focus of this report is on racial and ethnic inequities in the health care delivery system and therefore can be considered a first phase in a larger system-wide effort to eliminate all inequities that affect people’s health.

Please join us on Wednesday, December 13th for an event featuring key findings from a forthcoming report focused on developing a vision and action plan for achieving a racially and ethnically equitable health care delivery system in Massachusetts. Accompanying the report we will release a “Health Equity Action Plan Toolkit,” which identifies a comprehensive set of interventions, policies, and programs from around the country that can be deployed by health system leaders and other stakeholders to achieve health equity goals.

This in person event will include a presentation by our partners at Manatt Health who will describe the vision and plan for action—collectively the “Health Equity Action Plan”—for achieving a racially and ethnically equitable health care delivery system in Massachusetts. The agenda will also feature a panel of reactors that will speak to the proposed approach to launch this action plan in Massachusetts. A formal agenda and list of speakers will be shared prior to the event.

Registration is closed.