Massachusetts administers much of MassHealth through an 1115 Demonstration waiver, approved by the Centers for Medicare and Medicaid Services (CMS), which it has extended several times since it was originally approved in 1995. On September 28, 2022, CMS approved Massachusetts’ request for a five-year extension of its Demonstration, which is in effect from October 1, 2022 through December 31, 2027.
This issue brief aims to educate stakeholders and policymakers about an upcoming federal policy change that could impact coverage for many MassHealth members. Like all states, Massachusetts received enhanced federal Medicaid funding under the Families First Coronavirus Response Act (FFCRA), the first major federal stimulus package passed by Congress in response to the COVID-19 crisis in 2020. As a condition of receiving these funds, Massachusetts was required to maintain continuous coverage in MassHealth during the federal COVID-19 public health emergency.
Massachusetts administers much of MassHealth through an 1115 Demonstration waiver, approved by the Centers for Medicare and Medicaid Services (CMS), which it has extended several times since it was originally approved in 1995. In December 2021, Massachusetts submitted a request to CMS to extend its Demonstration for another five years.
This issue brief aims to educate stakeholders and policymakers about an upcoming federal policy change that could impact coverage for many MassHealth members. Like all states, Massachusetts received enhanced federal Medicaid funding under the Families First Coronavirus Response Act (FFCRA), the first major federal stimulus package passed by Congress in response
As a program that provides publicly-funded health benefits to more than 2 million low-income children and families, seniors and people living with disabilities in Massachusetts, it is not surprising that MassHealth accounts for a large share of the state’s budget. However, a cursory review of the MassHealth budget can be misleading because it can obscure the billions of dollars in federal revenue that the program generates for the state.
In response to the health and economic damage caused by the COVID-19 pandemic, Congress passed the American Rescue Plan Act (ARPA) in March 2021, which makes $1.9 trillion available to individuals, states and territories, counties, cities, community organizations, educational institutions, and other entities. Some funds are intended to shore up or even expand programs and agencies that have been depleted during the pandemic, while other funds are designated or available to create new programs.
Health care payers, providers, and policymakers are increasingly pursuing value-based payment (VBP) to improve the quality of care and population health while controlling rising health care costs. When implemented in Medicaid, VBP programs often include children and adults in the same model, though these models may not fully account for children’s distinct health needs.
This five-part series of issue briefs describes MassHealth’s impact on the health and finances of its members, families, and communities, as well as on the wide variety of stakeholders and sectors outside of the traditional health care realm that benefit from the program, including:
This report describes the results of a qualitative analysis of the MassHealth Accountable Care Organization (ACO) program over its first two years of operation. The Foundation commissioned this report to provide timely insight into what is working well, challenges stakeholders are facing, and opportunities to strengthen the program.
Of the more than 1.8 million people enrolled in MassHealth, Massachusetts’ Medicaid program, one in five are dually eligible and receive health care coverage through two distinct payers – Medicare and MassHealth. This educational primer was developed to build a deeper understanding of the dual eligible population in Massachusetts. It illustrates the diversity of dual eligible individuals’ clinical and functional needs, service utilization, and spending patterns.
Housing First programs offer chronically homeless individuals immediate housing as a foundation for the delivery of a range of other supportive services, such as mental health and/or substance use disorder services and social service supports.
The revised federal public charge rule – which was finalized in August 2019 and took effect in Massachusetts in February 2020 – makes it harder for certain low- and moderate-income immigrants to obtain green cards or visas if they have applied for or enrolled in public benefits such as MassHealth or the Supplemental Nutritional Assistance Program (SNAP). This report describes the expected effects of the revised federal public charge rule on MassHealth and SNAP enrollment, and its downstream effects on the health of Massachusetts residents, health care providers, and the state’s economy.
This brief builds upon a July 2018 publication, What to Know About ACOs: An Introduction to Accountable Care Organizations, which was developed as a resource for stakeholders (i.e., providers, health care administrators, and policymakers) to help explain the key elements of MassHealth ACOs, including the three types of ACOs, who they serve, and the services they provide.
This collection of materials goes beyond the topline statistics often used to characterize those served by MassHealth in order to paint a richer, more meaningful picture of the more than one in four Massachusetts residents enrolled in the program. MassHealth serves our most vulnerable residents across their life spans from infants and children with special needs who gain access to comprehensive health care and support services required to reach their full potential, to the elderly and those living with disabilities who receive community based care that helps them remain in their homes.
This brief describes the potential impact in Massachusetts of a proposed rule, released by the Department of Homeland Security in October 2018, to change the process by which it determines whether an immigrant is inadmissible to the United States or unable to adjust status because the person is likely to become a “public charge.” The proposed Public Charge Rule would mark a significant shift from current policy by defining a “public charge” as a noncitizen who receives one or more public benefits.
