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. This brief concludes with a series of detailed descriptions of the institutional and community LTSS covered under the Medicaid state plan that will eventually be integrated into ACOs and MCOs.

Based on valuable feedback from stakeholders this brief has been revised to better distinguish between certain services, in particular, adult foster care and group adult foster care.

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. However, we have now entered a policy limbo in which states are hopeful for reauthorization but must also determine other coverage options for children if funds run out.

As follow up to the Foundation’s June report, The Importance of CHIP Reauthorization for Massachusetts, this brief provides an update on the status of federal reauthorization for CHIP and a summary of its potential impact on the program in Massachusetts.

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.

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.

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.

The Blue Cross Blue Shield of Massachusetts Foundation, on behalf of the Massachusetts Coalition for Coverage and Care, funded a state-level analysis on the impact of the American Health Care Act (AHCA) on Massachusetts focused on 2022, when the law would be fully phased in.

Created by the Urban Institute’s Health Policy Center, this analysis uses state-level cost and coverage data from MassHealth (the state’s Medicaid program), the Massachusetts Health Connector Authority, and the Center for Health Information and Analysis. It is believed to be the first published study of the bill’s impact on an individual state.

This chart pack provides an overview of proposals to cap federal Medicaid funding and the considerations for Massachusetts.

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. Findings show that coupling supportive services like the type provided by CSPECH with permanent housing can lead to substantial improvements in housing stability and significant reductions in the utilization of acute health care services.

Findings from this report were featured at a Foundation event held on March 8, 2017. Click here to learn more about the event.

This issue brief describes the key elements of the most recent MassHealth 1115 waiver extension, including the shift to a delivery system centered on Accountable Care Organizations and Community Partners, a Delivery System Reform Incentive Program, the redesigned Safety Net Care Pool, and the expansion of services for treatment of substance use disorders. It concludes with a discussion of implications of the new system for major stakeholder groups.

This chart pack provides updated MassHealth enrollment data as of September 2016.

This budget brief highlights the fiscal year (FY) 2017 budget for MassHealth (Medicaid) and other subsidized health coverage programs. It is the last in a series of FY2017 budget briefs produced by the Massachusetts Medicaid Policy Institute (MMPI) in partnership with Health Management Associates.

In recent years, integrating treatment for mental health and substance use disorders (SUD) with primary care has been the subject of extensive research testing a number of different integration models and specific interventions. While many of these approaches have shown promise in demonstrations or clinical trials, the true test of value is in real-world settings where there are competing demands on scarce resources, strict fidelity to intervention protocols is difficult, and patients have multiple urgent needs. This report, prepared by a team led by Robin Clark and Deborah Gurewich of the University of Massachusetts Medical School, describes the process of providing integrated care for patients with SUD at three sites in central Massachusetts: Edward M. Kennedy Community Health Center, Family Health Center of Worcester, and Community Healthlink. It identifies common practices that improve care coordination for individuals with SUD and concludes with overarching key findings from the study.

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.

This brief describes the Massachusetts Senate fiscal year (FY) 2017 budget proposal for MassHealth (Medicaid) and other subsidized health coverage programs and compares it to the proposal put forth by the House. It is the third 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 process as proposals move through the state legislature.

Since 2001, the Blue Cross Blue Shield of Massachusetts Foundation (the Foundation) has supported community-based organizations, federally qualified health centers, and public agencies through its Connecting Consumers with Care grant program. During the October 2013 through September 2015 grant cycle, 16 organizations across Massachusetts received awards to help low-income and vulnerable consumers enroll in and maintain access to publicly subsidized health insurance coverage, and to help consumers navigate systems of coverage and care with increasing independence. This period coincided with the state’s implementation of key components of the Patient Protection and Affordable Care Act (ACA).

This report includes findings from the evaluation of the 2013-2015 Connecting Consumers with Care grant program. The goals of the evaluation were to 1) assess progress made on select outreach and enrollment measures, 2) describe the practices grantees adopted to reach and enroll consumers in health insurance, and 3) characterize efforts and challenges in defining, promoting, and evaluating consumer self-sufficiency.