Event Recordings:

Main Event 
Includes: Reflection on Past, Present, and Future of the Foundation; Presentation of Key findings from MassHealth Impacts Series; and Remarks by Marylou Sudders, Massachusetts Secretary of Health and Human Services
Breakout Session 1: MassHealth and the Behavioral Health System
Breakout Session 2: MassHealth and Schools and School-Aged Children
Breakout Session 3: MassHealth and Justice-Involved People
Foundation 20th Anniversary Timeline

Event Overview:

In 2001, when the Blue Cross Blue Shield of Massachusetts Foundation was established, almost 7% of Massachusetts residents (or 500,000 individuals) had no health insurance. During this time, MassHealth coverage and benefits were also being scaled back and rates of uninsurance were growing. Because of a collective cross sector effort that included consumer advocates, providers, insurers, employers, and the work of the Foundation, Massachusetts created a model of near-universal coverage, with MassHealth serving as the anchor for these successful reforms.

Fostering dialogue among stakeholders about MassHealth and promoting the development of effective policy solutions to address the challenges associated with this critical program and access to affordable coverage more broadly remains a key strategy in fulfilling the Foundation’s mission since its establishment. In 2021, the Foundation will continue to pursue solutions that create equitable access to coverage and eliminate barriers to care. 

On Wednesday, June 30^th the Foundation hosted a virtual event in recognition of its 20^th anniversary. We reflected on the past, present, and future of the Foundation with Foundation leadership including: our President and CEO, Audrey Shelto, and members of our Board of Directors - Andrew Dreyfus, President and CEO, BCBSMA and first President of the Foundation and Manny Lopes, President and CEO, East Boston Neighborhood Health Center, and current Chair of the Foundation’s Board of Directors.

Our colleagues at Manatt Health Strategies then shared findings from a series of issue briefs commissioned by the Foundation’s Massachusetts Medicaid Policy Institute about the key role of MassHealth on the health and finances of its members, families, and communities, as well as on the wide variety of stakeholders and sectors outside of the traditional health care realm that benefit from the program. And we heard reflections about MassHealth’s role and future in these realms from state leaders including Marylou Sudders, Massachusetts Secretary of Health and Human Services, providers, and consumers.

Guests had the opportunity to choose between breakout sessions that focus on MassHealth’s impacts on:

• the Commonwealth’s schools and school‐aged children, teens, and young adults;
• the behavioral health care system, addressing how MassHealth provides coverage, access, and delivery of services across the full behavioral health care continuum; and
• justice-involved persons, describing how MassHealth supports re-entry into the community

MassHealth, the cornerstone of health care coverage for more than 2 million people, contributes significantly to the state’s economic strength by drawing billions in federal funding, spurring widespread business activity and supporting a diverse workforce and their families, according to a new report from the Blue Cross Blue Shield of Massachusetts Foundation.

In its MassHealth Impact Series, a five-part analysis of the state’s Medicaid program, the Foundation notes that MassHealth brings in more than $8 billion annually in federal funding, an amount that is sevenfold larger than the next source of federal revenue, and that federal dollars cover nearly half the cost of the program.  The series of issue briefs also underscore that MassHealth is a critical source of coverage for the low-income workforce, and that the program becomes even more vital in downturns when more people lose their employer-sponsored health insurance coverage.

“MassHealth has a massive impact on the Commonwealth’s economy and its families – more than many people realize,” said Audrey Shelto, President and CEO of the Blue Cross Blue Shield of Massachusetts Foundation.  “As we have seen from the latest economic crisis during the COVID-19 pandemic, MassHealth provides a social safety net for families who lose access to coverage and ensures continuity in their health care.”

The Foundation will share findings from the MassHealth Impact Series during a virtual event on June 30 in recognition of the Foundation’s 20th anniversary.  Educating stakeholders and fostering dialogue about MassHealth has been a key strategy of the Foundation since its establishment in 2001 as the private, nonprofit organization that created the framework for the state’s health care reform law.

Providers, MassHealth members, advocates and state leaders, including Massachusetts Health and Human Services Secretary Marylou Sudders, will discuss MassHealth’s critical role in the state’s model of near-universal health coverage, improving educational outcomes for children, delivering behavioral health care services, and improving health outcomes and reducing recidivism among people involved in the justice system.  Speakers will also explore effective policy solutions for promoting equitable access to affordable care.

The MassHealth Impact Series was authored by Manatt Health Strategies and commissioned by the Foundation’s Massachusetts Medicaid Policy Institute.  The complete issue brief series is available online at: https://www.bluecrossmafoundation.org/publication/masshealth-impact-series.

To register for the Foundation’s 20th anniversary virtual event, click here.

About the Blue Cross Blue Shield of Massachusetts Foundation

The mission of the Blue Cross Blue Shield of Massachusetts Foundation is to expand access to health care for low-income and vulnerable individuals and families in the Commonwealth.  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.

This five-part series of issue briefs describes MassHealth’s impact on the health and finances of its members, families, and communities, as well as on the wide variety of stakeholders and sectors outside of the traditional health care realm that benefit from the program, including:

• the Commonwealth’s schools and school‐aged children, teens, and young adults;
• the state’s economy and businesses, including how MassHealth supports working families, reduces uncompensated care costs, and draws federal funds into the state;
• the behavioral health care system, addressing how MassHealth provides coverage, access, and delivery of services across the full behavioral health care continuum; and
• justice-involved persons, describing how MassHealth supports re-entry into the community.

Key findings from this series were featured at a Foundation virtual event on Wednesday, June 30^th from 2:00-4:00 pm. Click here to view event materials.

This report describes the results of a qualitative analysis of the MassHealth Accountable Care Organization (ACO) program over its first two years of operation. The Foundation commissioned this report to provide timely insight into what is working well, challenges stakeholders are facing, and opportunities to strengthen the program. The findings from this analysis are intended to fill a current gap in publicly available data evaluating the ACO program; they elevate the perspective of organizations operating within this new program, and can be used to help inform policymakers and administrators as they continue to build on and refine the ACO program.

This analysis was informed by a series of interviews with 34 individuals representing 21 organizations, including ACOs, managed care organizations, Long-Term Services and Supports and Behavioral Health Community Partners (CPs), Social Services Organizations (SSOs), and other stakeholders involved in the program. The following five key themes emerged from this research:

1. Interviewees overwhelmingly support the Accountable Care Organization program and praise MassHealth’s stakeholder engagement efforts to improve the program.
2. Interviewees report progress toward improving care delivery but acknowledge that making a measurable impact on health outcomes takes time.
3. The Accountable Care Organization program sparked the formation of beneficial partnerships among Accountable Care Organizations, Community Partners, and Social Service Organizations.
4. The Community Partner Program’s complexity created a burden for Accountable Care Organizations and Community Partners.
5. The Flexible Services Program is promising, but relationships between Accountable Care Organizations and Social Service Organizations could benefit from more structure.

To ensure future success of the ACO program, the report also makes specific programmatic recommendations for strengthening the program moving forward. These recommendations focus on: (1) supporting improved communication and data sharing among ACOs, CPs, and SSOs; and (2) addressing structural elements of the program that hinder partnerships in the CP and Flexible Services Programs.

Of the more than 1.8 million people enrolled in MassHealth, Massachusetts’ Medicaid program, one in five are dually eligible and receive health care coverage through two distinct payers – Medicare and MassHealth. This educational primer was developed to build a deeper understanding of the dual eligible population in Massachusetts. It illustrates the diversity of dual eligible individuals’ clinical and functional needs, service utilization, and spending patterns. The primer also describes the program options that are available to meet their needs, with a particular focus on MassHealth’s integrated care programs – One Care, the Program of All-Inclusive Care for the Elderly (PACE), and Senior Care Options (SCO). Also included in the primer is a description of the state’s proposed reforms, known as the Duals Demonstration 2.0, to increase enrollment in One Care and SCO and improve care integration and quality for dual eligible members.

The primer consists of four components:

• An issue brief, which provides an overview of the characteristics of dual eligible members in Massachusetts and the costs associated with their care, as well as of the coverage landscape for the state’s dual eligible individuals and key objectives of the Duals Demo 2.0;
   
• An in-depth comparative assessment of the integrated care programs available to dual eligible members in Massachusetts;
   
• A data chart pack, which offers a detailed analysis of enrollment, demographics, and spending trends among dual eligible individuals in Massachusetts; and
   
• A set of five profiles of dual eligible members enrolled in integrated care and fee-for-service delivery systems in Massachusetts.

The Blue Cross Blue Shield of Massachusetts Foundation today announced that twelve medical journalists from across the nation have been selected for the 2021 class of the Health Coverage Fellowship.

The 2021 fellows are Benjamin Bragdon of the Kennebec Journal/Morning Sentinel, Jenna Carlesso of the Connecticut Mirror, Caroline Covington of Texas Standard-KUT Radio, Alli Fam of New Hampshire Public Radio, Beth Healy of WBUR Radio in Boston, Ana Ibarra of CalMatters, Nadia Kounang of CNN, Fenit Nirappil of the Washington Post, Deanna Pan of the Boston Globe, Jennifer Portman of USA Today, Will Stribling of Mississippi Today, and Sarah Toy of the Wall Street Journal.

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 the world’s biggest brain bank.

The program, which is entering its twentieth year, is sponsored by the Blue Cross Blue Shield of Massachusetts Foundation, with support from the Blue Shield of California Foundation, Bower Foundation in Mississippi, Connecticut Health Foundation, Endowment for Health in New Hampshire, Maine Health Access Foundation, National Institute for Health Care Management Foundation, Robert Wood Johnson Foundation, and, in Texas, the Episcopal Health Foundation, Meadows Mental Health Policy Institute, Methodist Healthcare Ministries, and St. David’s Foundation.

The fellowship will run for nine days, beginning September 17, 2021. It is housed at Babson College’s Center for Executive Education 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 eight 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 pandemics to treating mental illness, rooting out racial biases, redressing homelessness, and rethinking end-of-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 stations or papers. 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 expand access to health care for low-income and vulnerable individuals and families in the Commonwealth.  The Foundation was founded 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.

This resource highlights the most recent monthly enrollment data available for MassHealth and ConnectorCare — the two most prominent sources of publicly financed health insurance in Massachusetts. The compiled data and highlighted trends described in this resource are intended to help policymakers, health care stakeholders, and others track how enrollment in these programs has changed since the COVID-19 pandemic began affecting public health and the economy of the Commonwealth. This resource will be updated regularly with the latest enrollment data as it becomes available.

Stay up to date on the latest updates to this enrollment tracker by signing up for our email list.

The Blue Cross Blue Shield of Massachusetts Foundation awarded more than $3 million in grants to 64 community-based programs and projects that promote sustainable improvements in health care access for low-income and uninsured residents of Massachusetts.  Over the past two decades, the Foundation has granted more than $73 million in total.

The grants were awarded in the second half of 2020 for initiatives continuing into 2021.  They include the Foundation’s four key grant-making program areas:

• Connecting Consumers with Care, which supports community-based organizations that assist eligible consumers with securing, maintaining, and navigating health insurance coverage.
• Expanding Access to Behavioral Health Urgent Care, which builds upon the state’s existing Emergency Services Program (ESP) system and expands the recipient organizations’ ability to provide community-based behavioral health urgent care.
• Going Beyond Health Care: Addressing Social Determinants Through a Cross-Sector Approach, which supports the coordination of services by interdisciplinary teams to address clinical and non-clinical needs of low-income and vulnerable populations.
• Strengthening the Voice for Access, which supports statewide organizations working on expanding access to health care and promoting the health care interests of low-income residents.

“With this round of grant-making, we remain steadfast in our multi-year commitments to expanding access to behavioral health urgent care, investing in new models to address the social determinants of health, strengthening statewide advocacy for health access, and supporting local efforts to obtain coverage for Massachusetts residents,” said Audrey Shelto, president of the Blue Cross Blue Shield of Massachusetts Foundation.  “At the same time, we are pleased to have distributed funds to community-based organizations responding to the pandemic in communities that have been inequitably impacted.”

The Foundation’s Special Initiatives program continued to provide one-time grants to nonprofits and projects that predominantly serve people of color, including some with a special focus on responding to community needs caused by COVID-19.

The following is a complete list of Foundation grantees:

Connecting Consumers with Care

Expanding Access to Behavioral Health Urgent Care

Going Beyond Health Care

Strengthening the Voice for Access

Special Initiatives

In addition, the Catalyst Fund, a grant program funded by employees of Blue Cross Blue Shield of Massachusetts and administered by the Foundation, awarded $78,740 in grants to 17 organizations across Massachusetts addressing COVID-19 in their communities.  The grants will help provide basic needs to the vulnerable populations the grantees serve, including individuals experiencing homelessness, older adults, individuals with disabilities, low-income and immigrant families, and youth with behavioral health conditions.

About the Blue Cross Blue Shield of Massachusetts Foundation

The mission of the Blue Cross Blue Shield of Massachusetts Foundation is to expand access to health care for low-income and vulnerable individuals and families in the Commonwealth.  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.

The Blue Cross Blue Shield of Massachusetts Foundation released a research report today demonstrating the effectiveness of supportive housing programs in reducing total health care costs for medical services provided by MassHealth (the Massachusetts Medicaid program) to chronically homeless individuals.  The study examined Housing First models administered by the Massachusetts Housing & Shelter Alliance (MHSA).

Researchers integrated claims data for a group of individuals, comparing expenditures before and after the provision of supportive housing services and with a control group of similar individuals who did not receive Housing First services.  Most of the Housing First participants in this study were enrolled in the Community Support Program for People Experiencing Chronic Homelessness (CSPECH), a Medicaid-funded program that provides community-based support services for chronically homeless individuals in Massachusetts.

Key findings of the study include:

• Individuals enrolled in permanent supportive housing programs had significantly lower per-person, per-year health care costs on average, compared with the cohort that didn’t receive such services.
• Individuals in the programs received significantly more mental health services but the cost was more than offset by lower utilization of inpatient and emergency department services.
• The evidence suggests that expansion of supportive housing models may produce health care cost savings and also have preventive effects of more consistent access to mental health services.

“This rigorous study adds to a growing body of research that demonstrates investments in social determinants of health – in this case supportive housing for the chronically homeless – not only lead to better health, but also provide a significant return in the form of lower Medicaid costs,” said Audrey Shelto, president of the Blue Cross Blue Shield of Massachusetts Foundation.  “When it comes to CSPECH, the data are in: People are getting more of the services that they need and at net lower cost.”

MHSA President and Executive Director Joe Finn said, “This study demonstrates that housing is the ideal solution for solving the recurrent and long-term homelessness of medically complex persons in Massachusetts.  At a time when this population is at high risk for illness, amid a global pandemic and harsh economic downturn, the research confirms that continuing to embrace this strategy is not only humane policy but responsive to a challenging fiscal environment.”

The Foundation provided a grant to support the research project, a collaborative effort among MHSA, economic consultants supported by Analysis Group Inc.’s pro bono program, the University of Denver, and the University of Massachusetts Medical School.

The full report, “The Preventive Effect of Housing First on Health Care Utilization and Costs Among Chronically Homeless Individuals: New Evidence Using Propensity Score Analysis,” can be found online at: https://www.bluecrossmafoundation.org/publication/preventive-effect-housing-first-health-care-utilization-and-costs-among-chronically

About the Blue Cross Blue Shield of Massachusetts Foundation

The mission of the Blue Cross Blue Shield of Massachusetts Foundation is to expand access to health care for low-income and vulnerable individuals and families in the Commonwealth.  The Foundation was founded 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, please visit www.bluecrossmafoundation.org.

About the Massachusetts Housing & Shelter Alliance

The Massachusetts Housing & Shelter Alliance (MHSA) is a nonprofit organization dedicated to ending homelessness in Massachusetts.  Through advocacy, collaboration, education, and innovative program development, MHSA focuses on evidence-based solutions that reduce public reliance on emergency resources and prioritize access to stable housing and individualized support services.  MHSA draws on the on-the-ground experience of its 89 member agencies from across Massachusetts to inform its advocacy and program development.  For more information, please visit www.mhsa.net.

Housing First programs offer chronically homeless individuals immediate housing as a foundation for the delivery of a range of other supportive services, such as mental health and/or substance use disorder services and social service supports. This report summarizes a study examining the effect of the Housing First model on health care utilization and costs among chronically homeless individuals enrolled in MassHealth. The findings from this study demonstrate the effectiveness of a permanent housing and supportive services program in reducing total health care utilization and costs among chronically homeless individuals.