Browse by Topic: Medicaid

Sharing Behavioral Health Information in Massachusetts: Obstacles and Potential Solutions

This report, prepared by Robert Belfort and Alex Dworkowitz of Manatt, Phelps & Phillips, LLP, provides a review of the primary Massachusetts and federal privacy laws relevant to the exchange of information among physical and behavioral health providers and an assessment of technological and operational challenges faced by providers seeking to integrate care through enhanced data exchange.

The Governor’s FY2017 Budget Proposal for MassHealth (Medicaid) and Health Reform Programs

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.

The Remaining Uninsured in Massachusetts: Experiences of Individuals Living without Health Insurance Coverage

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.

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 Using previously unpublished LTSS data, the chart pack examines MassHealth LTSS spending and utilization, access and affordability, workforce capacity and quality.

A Primer on Medicaid Managed Care Capitation Rates: Understanding How MassHealth Pays MCOs

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.

Minding the Gaps: The State of Coverage to Supplement Medicare in Massachusetts

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.

Implementing the Affordable Care Act in Massachusetts: Changes in Subsidized Coverage Programs

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.

Monitoring Access to Care in Massachusetts: Comparing Public Coverage with Employer-Sponsored Insurance Coverage

This report, prepared by Sharon Long and Thomas Dimmock of the Urban Institute, further analyzes the 2013 Massachusetts Health Reform Survey (MHRS) by comparing the experience of adults with public coverage to adults with employer-sponsored insurance (ESI) coverage across a number of access and affordability measures. Findings from the analysis show problems with access to care were more prevalent for adults with public coverage than for those with ESI.

Comparison of the FY2016 House and Senate Budget Proposals for MassHealth and Health Reform Programs

This brief describes the Massachusetts Senate fiscal year (FY) 2016 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 FY2016 budget briefs produced by the Massachusetts Medicaid Policy Institute (MMPI) in partnership with Rob Buchanan and Tom Dehner of Health Management Associates. MMPI will be publishing budget briefs at several stages in the FY2016 budget process as proposals move through the state legislature.

Coverage Options for Massachusetts: Leveraging the Affordable Care Act

In this issue brief, Patricia Boozang, Deborah Bachrach and Hailey Davis of Manatt Health Solutions, review the coverage and delivery system challenges that Massachusetts could address through sections 1331 (the Basic Health Program) and 1332 (Waivers for State Innovation) of the Affordable Care Act (ACA).