This report, prepared by Margaret Houy and Michael Bailit of Bailit Health Purchasing, LLC, provides a comprehensive review of the policy and regulatory barriers that impede behavioral health integration in Massachusetts and identifies potential options for addressing these barriers. This report is divided into three sections – licensing, privacy, and, reimbursement barriers – and was developed through a review of reports and other secondary sources, agency regulations and checklists, and interviews and a focus group with key stakeholders. Incorporating the input from the focus group, it concludes with a discussion of the top three priorities that, if addressed, would have the most significant impact on removing barriers to integration. This report is intended to serve as a resource summarizing key issues and potential opportunities for policymakers to improve the integration of physical and behavioral health care services.

In 2014, the Foundation partnered with the city of Boston to conduct a thorough analysis of the scope of Boston's substance use addiction problem and selected DMA Health Strategies to conduct the research. With the Mayor’s Office, the Foundation also assembled an Addiction Recovery Advisory Group comprised of addiction experts and community stakeholders to work closely with the researchers. This report, which focuses on how to better align the city of Boston’s addiction and recovery services with demonstrated best practices, will serve as a roadmap for the Mayor’s Office of Recovery Services.

Peter Hussey, Courtney Armstrong, and Eric Schneider of the RAND Corporation conducted interviews with seven health plans and five Accountable Care Organizations (ACOs) to determine their support for innovative delivery system models including payment arrangements, program development strategies, and the criteria decide whether or not to support these programs. All interviewees are currently engaged in innovative care delivery efforts aimed at improving quality and reducing the cost of healthcare and believe that the current payment system has not moved far enough away from fee-for-service to support meaningful delivery system changes. The report suggests that a shift towards alternative payment methodologies, an alignment of incentives across payers, and a better understanding of the impact of care delivery transformation are all necessary to achieve sustainability. The authors find that the main challenge in innovation will building capacity and managing financial risk, particularly for smaller and less-experienced provider organizations.

Click here to read the report.

Unless Congress acts, federal funding for the Children’s Health Insurance Program (CHIP) will run out soon after September 2015. On March 26, the U.S. House of Representatives passed legislation that would fund CHIP for two more years. The Senate is expected to take up the bill in mid-April. This report, written by Robert Seifert of the Center for Health Law and Economics at the University of Massachusetts Medical School, examines the serious implications for Massachusetts if federal funding for CHIP is not extended.

Megan Burns and Michael Bailit of Bailit Health Purchasing, LLC, provide a comprehensive review of payment reform in Massachusetts and, in particular, how the changing landscape is affecting safety-net providers. For this report, safety-net providers—those providers characterized by serving a high percentage of Medicaid beneficiaries and uninsured individuals—includes both community health centers and hospitals. Building off state-collected data that details the adoption of alternative payment models (APMs) by payers over the course of 2012 and 2013, the report adds qualitative findings gathered from a sample of payers and providers in mid-2014. The qualitative findings focus on the variation in characteristics of Massachusetts global payment arrangements and the impact the contracts are having on safety-net providers. The report concludes with several recommendations that payers, the state, or foundations could provide to aid safety-net providers in their preparation for payment reform.

This report, written by Robert Seifert, Michael Grenier, and Jean Sullivan of the Center for Health Law and Economics at the University of Massachusetts Medical School, summarizes the history of the MassHealth 1115 waiver and examines the key components of the new waiver extension, organized around five themes: coverage, services, delivery redesign, support for the safety net, and looking to the future. This most recent waiver extension, which the Centers for Medicare and Medicaid Services (CMS) granted in October 2014, is for five years (until June 30, 2019). However, a major component—the Safety Net Care Pool—was extended for only three years (until June 30, 2017), with the terms for the remaining two years subject to further negotiation.

In conjunction with the full report, the authors developed an abbreviated summary of the MassHealth 1115 waiver, which provides an overview of the new provisions approved under the waiver renewal.

Responsible for the health care coverage of nearly two million residents and $13.7 billion in related expenditures, the future of MassHealth matters to all of us. This report, by Manatt Health Solutions, includes a series of recommendations that emerged through interviews with consumer advocates, providers, insurers, business leaders, public officials, and policy experts as priorities for the next governor.

Findings from this report were featured at a Foundation event held on December 9, 2014, MassHealth Matters: Priorities for the New Administration. Click here to learn more about the event and to see a copy of the slide presentation of the report by Patricia Boozang, Managing Director of Manatt Health Solutions.

Click here to watch the MassHealth Matters video.

One Care is Massachusetts’ demonstration project for adults with disabilities between the ages of 21 and 64 who are dually eligible for Medicare and Medicaid. October 1, 2014 marked the first year anniversary of the demonstration, which is slated to run through December 31, 2016. The Commonwealth of Massachusetts and the Centers for Medicare and Medicaid Services (CMS) have jointly contracted with three health plans to provide all medical, behavioral health, dental, pharmacy, and long-term support services covered by Medicare and Medicaid and any other services as determined by the member's care plan.

This fact sheet provides a comprehensive description of One Care. The November 2014 edition includes updated information on the risk sharing arrangement and a summary of the findings from the Early Indicators Project consumer survey. The infographic includes updated One Care enrollment by health plan, rating category and geography as of October 1, 2014. Also included is new data on disenrollment, rating category enrollment penetration and rating category enrollment within each One Care Plan. MMPI plans to update the enrollment infographic on a regular basis as new information becomes available.

UPDATED chart pack, prepared by the Center for Health Law and Economics at the UMass Medical School, including summary data on MassHealth enrollment and spending. Designed to support use of the charts in presentations. Updated edition includes MassHealth enrollment as of December 31, 2013 and spending from FY 2013.

From 2001 through 2010, the Foundation awarded $10.5 million to 48 organizations across the Commonwealth through the Innovation Fund for the Uninsured. The organizations profiled in this report, along with the other grant recipients, were at the forefront of delivering higher-quality, more cost-effective care. They honed a number of strategies that remain instructive today, including team-based care, case management, coordination of physical health and behavioral health care, and the use of community health workers. Their stories can serve as lessons for other providers, funders, and policymakers who are committed to the promise of quality, affordable care for the most vulnerable.

Designed by Renessa Ciampa-Brewer, winner of a 2013 American Graphic Design Award.

From 2008 through 2011, the Foundation supported 11 community-based coalitions across Massachusetts through its Closing the Gap on Health Care Disparities Initiative. This report, prepared by Mary Coonan and Terry Saunders Lane of The Center for Social Policy, University of Massachusetts Boston, explores areas of coalition development, system change, and public awareness. It articulates strategies that worked well, challenges that emerged, and factors that explain variation to inform foundations, community organizations, and health care institutions working to address disparities in health care and outcomes. 

UPDATED chart pack, prepared by the Center for Health Law and Economics at the UMass Medical School, including summary data on MassHealth enrollment and spending. Designed to support use of the charts in presentations.

Summary of the MassHealth 1115 waiver renewal including a brief overview of four new provisions approved under the waiver renewal.

Report summarizing the results of a series of interviews conducted by the Center for Health Care Strategies with key Medicaid stakeholders from across the country on cutting-edge Medicaid strategies including: purchasing strategies to optimize delivery systems; payment strategies to leverage existing funds; integrated models of care to improve services for complex populations; and opportunities for improved organizational capacity.

Chart pack, prepared by the Center for Health Law and Economics at the UMass Medical School, including summary data on MassHealth enrollment and spending.  Designed to support use of the charts in presentations.