This chart pack provides updated MassHealth enrollment data as of November 2015.

This brief describes the governor's fiscal year (FY) 2017 budget proposal for MassHealth (Medicaid) and health reform programs. It is the first in a series of FY2017 budget briefs produced by the Massachusetts Medicaid Policy Institute (MMPI) in partnership with Health Management Associates. MMPI will be publishing budget briefs at several stages in the FY2017 budget cycle as proposals move through the state legislature.

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. This report, prepared by a team led by Michael Chin and Deborah Gurewich of the University of Massachusetts Medical School, and Audrey Gasteier of the Commonwealth Health Insurance Connector Authority, summarizes the findings of a qualitative study in which 33 uninsured individuals were interviewed about their experience living without health insurance. Findings from this study can help to better understand the remaining barriers to coverage and inform future strategies aimed at reducing the number of uninsured in the state. The report concludes with the personal stories of five individuals who have experienced first-hand the challenges and consequences of being uninsured.

On November 5, 2015, the Blue Cross Blue Shield of Massachusetts Foundation hosted a symposium for non-governmental users of the Massachusetts All-Payer Claims Database (MA APCD) administered by the Center for Health Information and Analysis (CHIA). This symposium updated users on the current state of the MA APCD, highlighted research that has been made possible as a result of the MA APCD, provided an opportunity to share best practices, and encouraged discussion about future opportunities to enhance the MA APCD in an effort to continuously support data-driven research and policy development in the Massachusetts health care sector. As a follow-up to the event, this summary, prepared by Amy Willis, Business Writing and Editing, highlights key takeaways and recommendations generated from the discussion.

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. It also includes a summary of opportunities to improve delivery and coordination of LTSS.

Findings from this chart pack were featured at a Foundation event held on December 2, 2015, MassHealth Matters II: Long-Term Services & Supports (LTSS): Opportunities for MassHealth.

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.

There are almost one million seniors in Massachusetts and while most enjoy broad coverage and protection against the cost of many health care services through Medicare, they may also face significant gaps, finding themselves responsible for substantial deductibles, coinsurance and copayments. This report, prepared by Nancy Turnbull and Katherine Heflin of Harvard T.H. Chan School of Public Health, reviews the many private and public coverage options available to seniors to supplement Medicare coverage. Using publicly available data from state and federal sources, this report examines recent trends and issues in private health insurance coverage and public programs to support payment of out-of-pocket costs for Medicare beneficiaries in Massachusetts.

This report summarizes the results of a July 2015 poll conducted by a team led by Robert J. Blendon, Sc.D. of Harvard T.H. Chan School of Public Health. The poll was conducted to assess the perspectives of Massachusetts adults age 65 and over on the issues of affordability, access, and satisfaction with their health care coverage. The results show that while a large majority of seniors are satisfied with the health care they receive as patients, over one-quarter of older adults are dissatisfied with health care costs, and more than one in five report that it has gotten harder to pay for health care services or prescriptions drugs over the past five years. Both concerns are higher among seniors who report poor health or a disability.

This updated edition of the tracking tool provides a detailed description of key components of Chapter 224, highlighting the progress the state has made in its implementation of the law as of August 2015. This tool is designed for policymakers, advocates, and other stakeholders who wish to track when and how state leaders have addressed policy issues pertaining to Chapter 224.

This tracking tool is a living document and will be updated annually. If you have any suggested additions or corrections, please email [email protected].

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. This issue brief, prepared by Health Management Associates, focuses on the changes in eligibility, benefits, cost sharing (including premiums), and health plan options available to individuals receiving subsidized insurance in the Commonwealth before and after implementation of the ACA.

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. This issue brief, prepared by Health Management Associates, focuses on the changes in eligibility, benefits, cost sharing (including premiums), and health plan options available to individuals receiving subsidized insurance in the Commonwealth before and after implementation of the ACA.

This budget brief highlights the fiscal year (FY) 2016 budget for MassHealth (Medicaid) and other subsidized health coverage programs. It is the last in a series of FY2016 budget briefs produced by the Massachusetts Medicaid Policy Institute (MMPI) in partnership with Rob Buchanan and Tom Dehner of Health Management Associates.

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.

UPDATED (July 2015) chart pack, prepared by the Center for Health Law and Economics at the UMass Medical School, includes summary data on MassHealth enrollment and spending and is designed to support use of the charts in presentations. Updated edition includes MassHealth enrollment as of March 2015 and spending from state fiscal year 2014.

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. This report, prepared by a team led by Elizabeth Bradley of the Yale Global Health Leadership Institute and Lauren Taylor of the Harvard Divinity School, evaluates and synthesizes the evidence base for interventions that address social determinants of health, with special attention to innovative models that may improve health outcomes and reduce health care costs and that may be applicable in the Massachusetts policy context. Based on this review, there is strong evidence that increased investment in select social services (e.g., housing support and nutritional assistance), as well as various models of partnership between health care and social services (e.g., integrated health care and housing services), can result in substantial health improvements and reduced health care costs for targeted populations.