Browse by Topic: Medicaid

The Proposed Public Charge Rule: An Overview and Implications in Massachusetts

This brief describes the potential impact in Massachusetts of a proposed rule, released by the Department of Homeland Security in October 2018, to change the process by which it determines whether an immigrant is inadmissible to the United States or unable to adjust status because the person is likely to become a “public charge.” The proposed Public Charge Rule would mark a significant shift from current policy by defining a “public charge” as a noncitizen who receives one or more public benefits.

How are Massachusetts Community-Based Organizations Responding to the Health Care Sector’s Entry into Social Determinants of Health?

In Massachusetts, MassHealth is implementing a number of reforms as part of its most recent Medicaid 1115 demonstration waiver extension to transform the delivery of care for most members and address the social determinants of health (SDOH). In light of the new interface between health care and social service delivery fostered by the MassHealth program redesign, it is important to understand how community-based organizations (CBOs) perceive the entry of health care organizations into their domains of social service delivery.

Addressing Major Drivers of MassHealth Per-Enrollee Spending Growth: An Analytic Review and Policy Options

This report seeks to inform the discussion of MassHealth sustainability through a novel analysis of MassHealth data that differentiates among the major drivers of MassHealth spending. The report examines whether spending is being driven by growth in enrollment or per-enrollee spending, and which populations or types of services are the biggest contributors to spending growth.

What to Know About ACOs: An Introduction to MassHealth Accountable Care Organizations

MassHealth introduced accountable care organizations (ACOs) for many of its members in March 2018. An ACO is a group of doctors, hospitals, and other health care providers that work together with the goals of delivering better care to members, improving the population’s health, and controlling costs. This brief serves as a resource for stakeholders (i.e., providers, health care administrators, policymakers) to help explain the key elements of MassHealth ACOs.

REVISED - A Guidebook to Social Services for MassHealth ACOs

This guidebook is designed to help health care administrators and providers better understand the types of social services available in Massachusetts, the organizations that provide such services, and their key sources of funding. This resource is intended to facilitate greater coordination between these organization types, and especially with MassHealth ACOs as they seek to integrate, better coordinate with social services, improve health outcomes, and reduce health care costs.

A History of Promoting Health Coverage in Massachusetts

This brief provides an overview of the steps that Massachusetts has taken to establish a functioning insurance market that provides consumers with meaningful access to health coverage. It includes a review of statutory and regulatory provisions in place today, and provides context for key health reform initiatives that have occurred over the past 30+ years. This brief is structured around four key components of a functioning market for health coverage:

Partnerships for Health: Lessons for Bridging Community-Based Organizations and Health Care Organizations

Given the impact that social factors have on health status and expenditures, and the shift toward value-based payment models that reward providers based on outcomes, health care organizations (HCO) and community-based organizations (CBO) across the country are increasingly working together to address patients’ social needs.

REVISED - Integrating MassHealth Long-Term Services and Supports: Considerations for ACOs and MCOs

This brief prioritizes issues for consideration as accountable care organizations (ACOs) and managed care organizations (MCOs) prepare to integrate and fully manage comprehensive long-term services and supports (LTSS) over the course of Massachusetts’ five year 1115 waiver extension. The identified priority areas were informed by lessons learned from managed LTSS programs in other states and interviews with key stakeholders in Massachusetts.

CHIP Reauthorization Update: Congressional Inaction Puts States in Limbo

Federal authorization for the Children’s Health Insurance Program (CHIP) expired on September 30, 2017. Senators Orrin Hatch (R-UT) and Ron Wyden (D-OR) have filed a bill to extend CHIP for five years, but Congress did not act quickly enough to prevent the current authorization from expiring. Unspent federal CHIP funds may be carried over into the next fiscal year and Massachusetts’s current allotment of federal CHIP funds should allow the state to continue to use CHIP funds for benefits until early 2018.

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.

Overview of the Senate Better Care Reconciliation Act of 2017

This chart pack provides an overview of the Senate-proposed Better Care Reconciliation Act of 2017, highlighting some of its key provisions, particularly as they relate to Medicaid. Developed by Manatt Health, this chart pack was commissioned by the Blue Cross Blue Shield of Massachusetts Foundation for the Massachusetts Coalition for Coverage and Care.

The Importance of CHIP Reauthorization for Massachusetts

This report describes the Children’s Health Insurance Program (CHIP) in Massachusetts and its role as part of MassHealth. Though there is no expiration date for CHIP in federal law, Congress has authorized funding of the program through September 30, 2017. Without Congressional action, a majority of states, including Massachusetts, will exhaust their current federal CHIP allocation by March 2018. This report discusses the importance of CHIP and the broader health policy debate, including reauthorization, now taking place in Washington.

Estimating Cost Reductions Associated with the Community Support Program for People Experiencing Chronic Homelessness

This report presents the results of a study analyzing the impact of the Community Support Program for People Experiencing Chronic Homelessness (CSPECH) on the utilization and cost of health care services. CSPECH is an innovative program through which MassHealth reimburses community-based support services provided to chronically homeless individuals residing in permanent supportive housing.