This UPDATED (October 2024) edition of the MassHealth: The Basics chart pack provides new data on MassHealth enrollment and spending from the most recent state fiscal years available. The chart pack features a high-level overview of the delivery systems that serve MassHealth members. It also highlights MassHealth’s latest reform efforts, which include initiatives to advance health equity, to expand services and coverage to certain groups, and to improve timely access to behavioral health care.

The chart pack provides comprehensive yet accessible data and explanations of program updates to help policymakers, administrators, advocates, and academics better understand the complex MassHealth program. It is made available in PDF and PowerPoint formats to facilitate its use in presentations.

On November 20, 2024, MMPI hosted a webinar to review facts and data about MassHealth eligibility, benefits and delivery systems, costs, and recent reforms from the latest edition of MassHealth: The Basics. Click here to access a recording of this webinar and a copy of the webinar slides.

Racial and ethnic disparities in health care access, quality, and outcomes have been well documented in Massachusetts and across the country. Solutions for reducing inequities in health require investments of time and resources for which there will always be competing priorities. In understanding the value of these investments, it is critical to recognize that in addition to the human toll, they represent a significant economic burden to individuals and families, health care providers, employers, public and private sector payers, and the overall Massachusetts economy. This study, commissioned by the Blue Cross Blue Shield of Massachusetts Foundation in collaboration with the Health Equity Compact, aims to quantify that economic burden.

This report provides an analysis of the impacts of the enhanced premium subsidies for purchasing health insurance through the Marketplace, or Health Connector in Massachusetts, that the American Rescue Plan Act (ARPA) temporarily authorized through 2022. While Massachusetts already provided additional state-based financial assistance to many marketplace enrollees prior to ARPA, ARPA enhanced subsidies for some individuals and introduced a new cap on the amount anyone purchasing through the Marketplace has to pay in premiums, effectively expanding eligibility for subsidies to purchase health insurance.

The Build Back Better Act that passed the House of Representatives and is currently stalled in the Senate would extend these subsidies through 2025. In this brief, we evaluate the coverage and cost effects of extending the enhanced subsidies in Massachusetts in 2023. The estimates suggest that, if extended, the enhanced subsidies would:

• reduce the number of people who are uninsured in Massachusetts by 8,000 people;
• reduce household spending on premiums for people who purchase subsidized coverage through the Health Connector; and
• save the state an estimated $133 million in spending on ConnectorCare subsidies in 2023.

The report provides a more detailed look at each of these effects and is intended to be a resource for health care advocates, policymakers, and other stakeholders to understand the impact of these subsidies expiring.

This budget brief highlights the state fiscal year (SFY) 2021 budget – which ran from July 1, 2020 through June 30, 2021 – for MassHealth and other health reform programs. The SFY21 budget was delayed by six months due to the COVID-19 pandemic and the resulting economic challenges and fiscal uncertainty. Included within the budget was $18.9 billion designated for health care coverage programs and related operational expenses. This brief provides an analysis of spending in the SFY2021 budget associated with MassHealth and other health care coverage and health reform activities, as well as a summary of new initiatives included in the SFY2021 budget that are expected to impact MassHealth program spending.

This UPDATED (October 2020) edition of the MassHealth: The Basics chart pack provides new data on MassHealth enrollment and spending from the most recent state fiscal years available, as well as a high-level overview and status update on the state’s delivery system reform efforts. The 2020 chart pack features a summary of the many temporary policy and programmatic changes that MassHealth quickly implemented in response to the COVID-19 pandemic.

The chart pack provides comprehensive yet accessible data points and updates on the complex MassHealth program that will be useful to policymakers and administrators, as well as advocates and academics. It is made available in PDF and PowerPoint formats to facilitate its use in presentations.

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. The findings suggest that as enrollment growth tied to previous coverage expansions levels off, the state will increasingly need to focus on controlling per-enrollee spending, particularly in the areas of pharmacy and long-term services and supports (LTSS).

Following a review of the findings, this report proposes a series of tailored policy options informed by other states’ strategies to further understand and address spending growth in the areas of pharmacy and LTSS.

The fourth edition of the 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 as of November 2017. This tool is designed for policymakers, advocates, and other stakeholders who wish to track when and how state leaders have addressed policy issues pertaining to Chapter 224.

This year’s release includes two distinct versions of the tracking tool: 1) An abbreviated version that focuses on progress the state has made since September 2016; and 2) A more comprehensive version which documents progress the state has made in implementing the law since its passage in 2012.

If you have any suggested additions or corrections, please email [email protected].

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.

The third edition provides a detailed description of key components of Chapter 224, highlighting the progress the state has made in its implementation of the law as of September 2016. This tool is designed for policymakers, advocates, and other stakeholders who wish to track when and how state leaders have addressed policy issues pertaining to Chapter 224.

This year’s release includes two distinct versions of the tracking tool: 1) An abbreviated version that focuses on progress the state has made since August 2015; and 2) A more comprehensive version which documents progress the state has made in implementing the law since its passage in 2012.

This tracking tool is a living document and will be updated annually. If you have any suggested additions or corrections, please email [email protected].

This report, prepared by Manatt Health, lays out a vision for MassHealth long-term services and supports (LTSS) that is person-centered, integrated, sustainable, accountable, and actionable, providing Massachusetts policymakers with a set of options to consider when tackling some of the most intractable challenges facing the Commonwealth’s LTSS system.

The vision and policy areas addressed in the report were identified through the development of a data chart pack and supplemental interviews with consumers, government officials, community and institutional LTSS providers, health plans, and workforce representatives.

Findings from this report were featured at a Foundation event held on May 10, 2016, MassHealth Matters II: Options for Reforming Long-Term Services and Supports. Click here to learn more about the event.

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.

On November 5, 2015, the Blue Cross Blue Shield of Massachusetts Foundation hosted a symposium for non-governmental users of the Massachusetts All-Payer Claims Database (MA APCD) administered by the Center for Health Information and Analysis (CHIA). This symposium updated users on the current state of the MA APCD, highlighted research that has been made possible as a result of the MA APCD, provided an opportunity to share best practices, and encouraged discussion about future opportunities to enhance the MA APCD in an effort to continuously support data-driven research and policy development in the Massachusetts health care sector. As a follow-up to the event, this summary, prepared by Amy Willis, Business Writing and Editing, highlights key takeaways and recommendations generated from the discussion.

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. It also includes a summary of opportunities to improve delivery and coordination of LTSS.

Findings from this chart pack were featured at a Foundation event held on December 2, 2015, MassHealth Matters II: Long-Term Services & Supports (LTSS): Opportunities for MassHealth.

This updated edition of the 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 as of August 2015. This tool is designed for policymakers, advocates, and other stakeholders who wish to track when and how state leaders have addressed policy issues pertaining to Chapter 224.

This tracking tool is a living document and will be updated annually. If you have any suggested additions or corrections, please email [email protected].

The “ Making Health Care Affordable” (MHCA) three-year grant program concluded in 2014. Margaret Houy and Kate Bazinsky of Bailit Health Purchasing, LLC report on the impact of the BCBSMA Foundation’s funding initiative. The goal of MHCA was to fund interventions aimed at containing costs while increasing access and quality of care. Bailit examines how the Foundation’s objectives were met, what factors led to successful program implementation, common barriers faced by grantees, and which programs may have generalizability.

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].

This glossary, prepared by the Blue Cross Blue Shield of Massachusetts Foundation with input from the Center for Health Information and Analysis and the Health Policy Commission, defines some of the key cost containment terms necessary to understand Chapter 224 of the Acts of 2012 and the health care cost dialogue in Massachusetts.

This comprehensive chartpack features, in one easy-to-use resource, data and complete references on topics including Massachusetts health care spending trends, cost drivers, and variations in pricing, as well as key differences in health care cost trends between Massachusetts and the U.S. This chartpack pulls together many of the major findings and analyses from recent state and national research efforts including reports by the Massachusetts Center for Health Information and Analysis and the Massachusetts Attorney General’s Office, as well as analyses by the Centers for Medicare and Medicaid Services and the Dartmouth Atlas of Health Care.

This chartpack was originally assembled by the Foundation in collaboration with Amitabh Chandra at the Harvard Kennedy School of Government and Josephine Fisher at Amherst College, and updates have been made by Foundation staff. This document has been designed to support the use of the charts in slide presentations, and we encourage readers to use them. We plan to update this chart pack regularly.

These fact sheets highlight the major implications of Massachusetts’s 2012 health care cost containment law, Chapter 224, for four key stakeholder groups:  hospitals, health plans, consumers, and clinicians. From increased data reporting requirements for hospitals and health plans, to greater cost transparency for consumers, Chapter 224 will have significant impacts on many aspects of the Massachusetts health care system in the years ahead.

For a comprehensive overview of the entire law, see the Foundation’s report: Summary of Chapter 224 of the Acts of 2012. For an in-depth look at the Medicaid provisions in the law, see the Foundation’s report: Chapter 224 of the Acts of 2012: Implications for MassHealth.

This report, written by Robert Seifert and Rachel Gershon of the Center for Health Law and Economics at UMass Medical School, examines the key components of the most recent Massachusetts health reform law - Chapter 224 of the Acts of 2012 - as they pertain to the Massachusetts Medicaid program (“MassHealth”). Under the new law, MassHealth will be subject to the annual spending growth benchmark and will be required to implement alternative payment arrangements for most of its members, among other new requirements and responsibilities.  For a broader overview of Chapter 224 of the Acts of 2012, see the Foundation’s report: Summary of Chapter 224 of the Acts of 2012. For additional information about scheduled stakeholder meetings, grant opportunities, and other implementation updates, see the state's website, Implementing Health Care Cost Containment.