MassHealth: The Basics – Facts and Trends (October 2020)

This UPDATED (October 2020) edition of the MassHealth: The Basics chart pack provides new data on MassHealth enrollment and spending from the most recent state fiscal years available, as well as a high-level overview and status update on the state’s delivery system reform efforts. The 2020 chart pack features a summary of the many temporary policy and programmatic changes that MassHealth quickly implemented in response to the COVID-19 pandemic.

The chart pack provides comprehensive yet accessible data points and updates on the complex MassHealth program that will be useful to policymakers and administrators, as well as advocates and academics. It is made available in PDF and PowerPoint formats to facilitate its use in presentations.

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MassHealth: The Basics – Facts and Trends (July 2019)

This UPDATED (July 2019) edition of the MassHealth: The Basics chart pack provides new data on MassHealth enrollment and spending from the most recent state fiscal years available, as well as a high-level overview and status update on the state’s delivery system reform efforts. The 2019 chart pack features a summary of the program’s impacts on access to care and health outcomes and new data highlighting the role of MassHealth in supporting the low-income workforce. The chart pack provides comprehensive yet accessible data points and updates on the complex MassHealth program that will be useful to policymakers and administrators, as well as advocates and academics.

Some of the key information from the 2019 chart pack -- which is organized under three sections, Eligibility and Enrollment, Spending and Cost Drivers, and Reforms -- includes:

  • MassHealth enrollment has been relatively stable for the past four years (2015-2018), hovering just above 1.8 million members. Notably:
    • More than 4 in 10 children in Massachusetts are MassHealth members; and
    • More than three quarters of non-elderly MassHealth members live in working families.
  • MassHealth represents a significant portion of the state budget, but the majority of its spending is paid for with federal funding, and spending growth has moderated in recent years as enrollment has leveled off.
    • From 2013-2016, prescription drugs and home- and community-based long-term services and supports (LTSS) were the key drivers behind per-enrollee spending growth in MassHealth.
  • MassHealth’s delivery system reform changes are well underway. Status updates are included on major initiatives:
    • Newly formed Accountable Care Organizations, which began full operation in March 2018, now have over 890,000 MassHealth members enrolled.
    • Launch of the Community Partners and Flexible Services programs to improve integration of behavioral health, LTSS, and social services.
    • Expansion of coverage for outpatient, residential inpatient, and community services to combat the substance use disorder crisis.

The chart pack is made available in PDF and PowerPoint formats to facilitate its use in presentations. A webinar to review this updated chart pack was held on October 29, 2019. A recording of that webinar is available here.

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Faces of MassHealth: Portrait of a Diverse Population

This collection of materials goes beyond the topline statistics often used to characterize those served by MassHealth in order to paint a richer, more meaningful picture of the more than one in four Massachusetts residents enrolled in the program. MassHealth serves our most vulnerable residents across their life spans from infants and children with special needs who gain access to comprehensive health care and support services required to reach their full potential, to the elderly and those living with disabilities who receive community based care that helps them remain in their homes. This detailed set of data and narrative profiles of MassHealth enrollees illustrate many of the life circumstances that create a need for MassHealth, and the various ways that MassHealth impacts individuals and their families. Fully understanding who MassHealth enrollees are and hearing from them about the role MassHealth plays in their lives is critical to informing policy and program development.

This project includes the following components:

  1. A chart pack summarizing the demographic and socioeconomic characteristics of individuals enrolled in MassHealth as of June 2018.
  2. Five journalistic profiles of a diverse set of real MassHealth members.
  3. A databook that provides more detail on the quantitative findings presented in the chart pack.

MassHealth: The Basics (September 2017)

UPDATED (September 2017) 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 May 2017 and spending from state fiscal year 2016. It is made available in PDF and PowerPoint formats to facilitate its use in presentations.

The Foundation hosted a webinar with author Bob Seifert from the Center for Health Law and Economics, University of Massachusetts Medical School to review the updated summary data on MassHealth enrollment and spending on Wednesday, October 11, 2017. Click here to access the webinar materials.

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UPDATED MassHealth: The Basics (June 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.

The Foundation hosted a webinar with authors Bob Seifert and Carol Gyurina from the Center for Health Law and Economics, University of Massachusetts Medical School to review the updated summary data on MassHealth enrollment and spending on Wednesday, June 29, 2016.

Click here to access the webinar slides.

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MassHealth Matters II: Long-Term Services & Supports: Opportunities for MassHealth

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.

UPDATED MassHealth: The Basics - Facts and Trends

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.

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