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.
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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:
UPDATED! Promoting Access to Care and Coverage During a Public Health Crisis: COVID-19–Related Changes Affecting MassHealth, Health Connector, and Health Safety Net
Massachusetts, with support from the federal government, has implemented several policy and programmatic changes intended to promote continued access to health care services and health insurance coverage during the COVID-19 public health emergency. This table serves as a centralized resource that documents and describes the policy, regulatory, and administrative actions pertaining to MassHealth, Health Connector programs, and the Health Safety Net.
The MassHealth Accountable Care Organization Program: Uncovering Opportunities to Drive Future Success
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.
This resource highlights the most recent monthly enrollment data available for MassHealth and ConnectorCare — the two most prominent sources of publicly financed health insurance in Massachusetts. The compiled data and highlighted trends described in this resource are intended to help policymakers, health care stakeholders, and others track how enrollment in these programs has changed since the COVID-19 pandemic began affecting public health and the economy of the Commonwealth. This resource will be updated regularly with the latest enrollment data as it becomes available.
The Preventive Effect of Housing First on Health Care Utilization and Costs Among Chronically Homeless Individuals
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.
This educational brief describes the key elements of the Affordable Care Act (ACA) and provides an overview of California v. Texas, a case currently before the U.S. Supreme Court that seeks to overturn the ACA. Also included in this brief is a discussion of recent relevant case history and how the arguments in California v. Texas build upon prior legal challenges to the ACA.
Potential Coverage and Federal Funding Losses for Massachusetts if California v. Texas Ultimately Overturns the Affordable Care Act
California v. Texas, a case currently before the U.S. Supreme Court, seeks to overturn the Affordable Care Act (ACA). The court is expected to begin hearing arguments on this case on November 10, 2020. A final ruling that overturns the ACA would have widespread implications, affecting every state in the nation.
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 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 UPDATED (July 2019) 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 2019 chart pack features a summary of the program’s impacts on access to care and health outcomes and new data highlighting the role of MassHealth in supporting the low-income workforce.
Among state budget items, MassHealth is well known as one of the largest spending categories, while its role as a significant source of federal revenue is often overlooked. This brief takes a look beyond the budget totals to help stakeholders better understand the actual state cost of MassHealth when factoring in the state and federal partnership that finances this program. In fiscal year (FY) 2019, the state projects it will spend approximately $16.7 billion on MassHealth. This total (or “gross” amount) is approximately 36 percent of total estimated state spending for FY 2019.
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.