New Report Recommends MassHealth Priorities for Baker Administration

Tuesday, December 9, 2014

CONTACT: Julie Burns
(617) 246-3361 / [email protected]

New Report Recommends MassHealth Priorities for Baker Administration
Massachusetts Medicaid Policy Institute Report Outlines Five Recommendations
For Immediate Action by New Administration

BOSTON – December 9, 2014 – With a new governor-elect and new members of the state legislature, the Massachusetts Medicaid Policy Institute (MMPI), a program of the Blue Cross Blue Shield of Massachusetts Foundation, released a report by Manatt Health Solutions on key priorities for MassHealth over the next four years. The report, based on over 40 interviews with stakeholders and policy experts, provides a critical discussion around the key issues, opportunities and policy options for MassHealth, a nearly $14 billion program – approximately 35% of the total state budget – that covers 1.7 million individuals and provides funding to healthcare providers that employ thousands of people. MassHealth is jointly funded by the state and federal governments and is expected to bring in $7.7 billion in federal revenue this fiscal year.

“Given the scope of MassHealth and its impact on the lives of our most vulnerable neighbors, we have a unique opportunity to take a fresh look at the program and its role in our health care system as the Governor-elect takes office,” said Audrey Shelto, President of the Blue Cross Blue Shield of Massachusetts Foundation. “The future of MassHealth– and its place in state government – must be addressed so that it can more effectively be governed and play a greater role in advancing delivery and payment reform in the Commonwealth.”

MassHealth is responsible for the healthcare of one out of four residents of the Commonwealth, three out of four low-income children, two out of three seniors in nursing homes and over half of the population of people with disabilities. “MassHealth touches so many lives that it can – and must – stand on the front lines of one of the most important health care debates facing our entire community,” said Phil Johnston, Chair of the Blue Cross Blue Shield of Massachusetts Foundation Board of Directors. “With this report, the Foundation stands ready to help the Baker Administration tackle these challenges and work collaboratively toward reform.”

Among the issues and concerns raised by stakeholders, five priorities emerged as those requiring the urgent attention of the Governor-elect to ensure the long-term strength and stability of the MassHealth program:

1) Elevate and Consolidate MassHealth Leadership. The beginning of a new administration is an ideal opportunity to set a clear purpose, vision, and strategy that will drive MassHealth priorities for at least the next four years. MassHealth must have empowered leadership with the skills, authority, and accountability to implement the Governor’s strategic direction.

2) Leverage MassHealth’s Purchasing Power to Accelerate Delivery System Reform. There is significant opportunity for MassHealth to more effectively use its clout as a purchaser to accelerate payment reform and delivery system transformation for the benefit of MassHealth enrollees and the Commonwealth overall.

3) Lead Behavioral Health Delivery and Payment Reform. The consensus of stakeholders is that Commonwealth residents impacted by mental illness and substance use disorders are unable to access the treatment they need. MassHealth must lead the Commonwealth in addressing these issues because of its role as a major payer for behavioral health services and programs, and because its membership disproportionately relies on these services.

4) Tackle Comprehensive Long-Term Care Reform. The costs of long-term care and support services for a large and growing number of seniors and people with disabilities adds up to a looming budget crisis. As the primary payer of these services, MassHealth’s greatest opportunity for a sustainable future is to take on the complex task of reforming long-term care delivery and funding systems.

5) Invest in MassHealth Infrastructure. Transformation and innovation require investment both in the people and technology that MassHealth needs to implement a new Governor’s agenda.

“Many states are grappling with very similar challenges to those facing Massachusetts, particularly the need for behavioral health and long-term care delivery system and payment reform. The new Governor has a chance to not only lead MassHealth reform in these areas, but to develop a framework for other states just as the Commonwealth has done with insurance coverage reform,” said Patricia Boozang, Managing Director of Manatt Health Solutions, and co-author of the report.

Interviews for the report were conducted from July through September of 2014 with a range of individuals regarding the major opportunities and challenges that face the next administration. Those interviewed include representatives of the provider and business community, insurers, consumers, and state and federal government, as well as Medicaid policy experts and former commissioners and directors.

For the full report and associated publications, please visit


The mission of the Blue Cross Blue Shield of Massachusetts Foundation is to expand access to healthcare for low-income and vulnerable individuals and families in the Commonwealth. The Foundation was founded in 2001 with an initial endowment from Blue Cross Blue Shield of Massachusetts. It operates separately from the company and is governed by its own Board of Directors.

The Massachusetts Medicaid Policy Institute (MMPI)—a program of the Blue Cross Blue Shield of Mas-sachusetts Foundation—is an independent and nonpartisan source of information and analysis about the Massachusetts Medicaid program, MassHealth. MMPI’s mission is to promote the development of effective Medicaid policy solutions through research and policy analysis.

Manatt Health Solutions (MHS) is the interdisciplinary health policy and business strategy advisory division of the law firm of Manatt, Phelps & Phillips, and LLP. As an integrated law and consulting firm, Manatt offers a unique combination of legal, policy, and operational expertise drawn from a team of 80 attorneys, policy advi-sors, business strategists, project managers, and financial analysts with extensive experience working with foundations, federal and state government, providers, health plans, and other industry leaders.