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.

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.

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.

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:

• A five-page summary report;
• A full narrative report;
• A chart pack;
• A methodology report and a copy of the survey instrument.

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.

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.

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.

This budget brief highlights the FY2015 budget for MassHealth and other subsidized health coverage programs. It is the last in a series of FY2015 budget briefs produced by MMPI in partnership with the Massachusetts Budget and Policy Center and the Massachusetts Law Reform Institute.

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 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.

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.

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.

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.

UPDATED chart pack, prepared by the Center for Health Law and Economics at the UMass Medical School, including summary data on MassHealth enrollment and spending. Designed to support use of the charts in presentations. Updated edition includes MassHealth enrollment as of December 31, 2013 and spending from FY 2013.

Affordability Gap Remains Despite Coverage Gains

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 since 2006. This round of the survey, which was fielded in the fall of 2012, was jointly funded by the Robert Wood Johnson Foundation and the Blue Cross Blue Shield of Massachusetts Foundation. These results provide both a means for continuing to monitor the efforts in Massachusetts to sustain the coverage gains achieved through the 2006 health reform law and an important new baseline against which to assess the impact of the state’s efforts to improve the affordability of care and reduce health care spending. Findings show that while coverage and access to care remain strong in Massachusetts, health care costs continue to be a burden for many individuals and families.  

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

• a five page summary, including comparing Massachusetts to the nation
• a series of infographics focused on the following topics: coverage, changing patterns of care, medical debt;
• a policy brief analyzing the impact of health care costs in depth;
• a full report; and,
• a chart pack.

For those interested in learning more about the methodology of the survey, please see this report and this survey instrument tool.

The Blue Cross Blue Shield of Massachusetts Foundation and the Robert Wood Johnson Foundation will be making the complete survey results for all six years of the survey available for public use through the Inter-university Consortium for Political and Social Research.

Findings from the survey were featured at a Foundation event on March 26, 2014. See materials from the event located here.

This chartpack summarizes the impact of the 2006 Massachusetts health reform law. The chartpack gathers data from surveys and analyses by state government agencies including the Massachusetts Center for Health Information and Analysis, the Massachusetts Department of Revenue, and the Massachusetts Health Insurance Connector Authority, as well as highlights from health reform tracking surveys conducted by the Urban Institute. 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 chartpack regularly.