MassHealth and the Importance of Continued Federal Funding for CHIP

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.

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The Geography of Uninsurance in Massachusetts, 2009-2013

This brief and set of detailed tables, prepared by Sharon Long and Thomas Dimmock from the Urban Institute, provide estimates of the number and rate of uninsurance in Massachusetts by various geographic units ranging from congressional districts to counties to neighborhoods. The resource is based on the 2009 to 2013 five-year file of the American Community Survey (ACS), which included a sample of 140,001 people in Massachusetts.

The brief summarizes high level findings from the data and definitions for the geographic units of analysis. The appendices provide data on the estimates of the number and rate of uninsurance by the following categories: all persons, males, females, children (ages 0-17), non-elderly adults (ages 18-64), and elderly (ages 65+). Each appendix provides these results for 10 different geographic units ranging from congressional district to county to census tract.

Alternative Payment Models and the Case of Safety-Net Providers in Massachusetts

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.

Summary of the MassHealth 1115 Waiver

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.

The Future of MassHealth: Five Priority Issues for the New Administration

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.

2013 Massachusetts Health Reform Survey

Affordability Still a Challenge

This collection of reports and chart packs is the latest in a series by the Urban Institute analyzing the results of the Massachusetts Health Reform Survey (MHRS), which has been conducted annually since 2006. This round of the survey, which was fielded in the fall of 2013, was jointly funded by the Blue Cross Blue Shield of Massachusetts Foundation and the Robert Wood Johnson Foundation. These results provide a means for continuing to monitor the efforts in Massachusetts to sustain the coverage gains achieved through the 2006 health reform law. In addition, the 2013 MHRS provides a new baseline for assessing the impacts of the state's efforts to improve the affordability of care and reduce health care spending because it coincides with the first full year under the provisions of Chapter 224 of 2012 and precedes the roll-out of major changes under the Affordable Care Act (ACA) that began in January 2014. Findings show that while Massachusetts has maintained high levels of health insurance coverage and health care use, the cost of care continues to remain a significant burden, especially for low- and middle-income individuals and families.

This year’s results are presented in a variety of publications including:

In an effort to expand opportunities for researchers to understand the experience of Massachusetts consumers with accessing and affording health care, the Blue Cross Blue Shield of Massachusetts Foundation and the Robert Wood Johnson Foundation will be making available a public use file of the 2013 surveys as they did with the previous years' surveys (i.e., 2006 - 2010, 2012). The 2012 public use files will be available through the Inter-University Consortium for Political and Social Research.

Understanding the Actual Cost of MassHealth to the State

This brief describes the "net" state cost of MassHealth (determined by subtracting the federal reimbursement and similar revenues from the budgeted total), providing a much clearer picture of the impact of MassHealth on the state budget than state budget totals alone. It is a supplement to a series of FY2015 budget briefs produced by MMPI in partnership with the Massachusetts Budget and Policy Center.

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UPDATED Massachusetts One Care Initiative for Non-elderly Dual Eligibles

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.

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Chapter 224 Tracking Tool

This tracking tool provides a detailed description of key components of Chapter 224, highlighting the progress the state has made in its implementation of the law. This tool is designed for policymakers, advocates, and other stakeholders who wish to track when and how state leaders may address policy issues that pertain to Chapter 224. This tracking tool is a living document and will be updated regularly. If you have any suggested additions or corrections, please email [email protected].

2011-2013 Connecting Consumers with Care Grant Area Evaluation

This report includes findings from the evaluation of the 2011-2013 Connecting Consumers with Care grant program. The goals of the evaluation were to 1) assess progress made across grantee sites on select outreach and enrollment measures; 2) describe the practices grantees adopted to reach out to and enroll consumers in insurance, advance consumer self-sufficiency, and collaborate with other agencies; and 3) characterize the barriers experienced by grantees. 

For a one-page infographic of the 2011-2013 evaluation report, click here.

 

Investing in Consumer Health Advocacy through Operating Support, Strengthening the Voice for Access: 2011-2013

This report demonstrates how a general-operating-funds approach to grantmaking can forge stronger and more effective partnerships between the philanthropy and consumer health advocacy communities. It includes examples of the positive impact this approach has had on access to health care in Massachusetts and highlights some of the activities and achievements of 2011-2013 Strengthening the Voice for Access grantee organizations.

Comparison of the FY 2015 House and Senate Budget Proposals for MassHealth and Health Reform Programs

This budget brief compares the Massachusetts House of Representatives and the Massachusetts Senate Fiscal Year (FY) 2015 budget proposals for MassHealth (Medicaid) and other subsidized health coverage programs. It is the third in a series of FY 2015 budget briefs produced by the Massachusetts Medicaid Policy Institute (MMPI) in partnership with the Massachusetts Budget and Policy Center and the Massachusetts Law Reform Institute. MMPI will be publishing budget fact sheets at several stages in the FY 2015 budget process, as proposals move through the state legislature.

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The House FY 2015 Budget

This brief describes the Massachusetts House of Representatives Fiscal Year (FY) 2015 budget proposal for MassHealth (Medicaid) and other subsidized health coverage programs. It is the second in a series of FY 2015 budget briefs produced by the Massachusetts Medicaid Policy Institute (MMPI) in partnership with the Massachusetts Budget and Policy Center and the Massachusetts Law Reform Institute. MMPI will be publishing budget fact sheets at several stages in the FY 2015 budget process, as proposals move through the state legislature.

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