In 2013, Massachusetts launched One Care, an integrated care program that serves dual eligible individuals with disabilities age 21 to 64 (at the time of enrollment). One Care aims to coordinate Medicare and Medicaid benefits, streamline services and financing through a single health plan, and help its members live independently and thrive in the community. The program serves around 42,000 dual eligible members in Massachusetts.

The federal authority under which One Care has operated is ending as of December 31, 2025. The Commonwealth will need to transition the program to a new authority. While the One Care program itself will remain, operating it under a new authority with different rules and structures means there will be some program changes. However, Massachusetts has designed a plan to preserve the care model and benefits of One Care, and adopted alternative approaches to providing as integrated an experience for members as possible.

The purpose of this report is to provide background on the One Care program as it exists today and to educate policymakers, advocates, and other stakeholders of One Care’s upcoming transition to a new federal authority. 

NOTA: Este informe también está disponible en inglés. Consulte nuestra página de inicio en español para este informe aquí. 

In light of increased efforts by MassHealth and other Medicaid agencies to engage with individuals who have lived experience with Medicaid and in order to improve health outcomes and advance equity, the Foundation commissioned two informative reports. The first report, Strategies for Meaningfully Engaging MassHealth Members to Inform Program and Policy Decisions, was released in June 2024 and made a series of recommendations to strengthen MassHealth’s overall member engagement strategy. 

This second report takes a deeper look at one specific member engagement tool: Community Advisory Boards (CABs.) CABs are groups of people including current and former Medicaid members that engage in structured, consistent, and long-term dialogue to inform Medicaid program and policy design. MassHealth, managed care organizations, and Accountable Care Organizations already employ CABs to inform specific MassHealth programs, and MassHealth has announced its intention to create a program-wide CAB.

This report aims to identify promising practices for design and implementation of CABs in the context of MassHealth. Based on an environmental scan, stakeholder interviews, and conversations with MassHealth members themselves, this report outlines guiding principles or “north stars” for establishing a CAB. It also details practical recommendations for designing and operating effective CABs. 

NOTE: This report is also available in English. Click here to view the report in English.

A la luz de los crecientes esfuerzos de MassHealth y otras agencias de Medicaid para colaborar con las personas que han vivido la experiencia de Medicaid y con el fin de mejorar los resultados de salud y avanzar en la equidad, la Fundación encargó dos reportes informativos. El primer reporte, Estrategias para Involucrar Significativamente a los Miembros de MassHealth para Informar las Decisiones de Programas y Políticas, se publicó en junio de 2024 e hizo una serie de recomendaciones para reforzar la estrategia general de participación de los afiliados de MassHealth.

Este segundo informe examina en profundidad una herramienta específica de participación de los afiliados: Los Consejo de Asesores Comunitarios (CABs). Los CABs son grupos de personas, incluidos miembros actuales y antiguos de Medicaid, que participan en un diálogo estructurado, coherente y a largo plazo para informar sobre el diseño de políticas y programas de Medicaid. MassHealth, las organizaciones de atención administrada y las organizaciones de atención responsable ya emplean CABs para informar programas específicos de MassHealth, y MassHealth ha anunciado su intención de crear CABs para todo el programa.

Este informe busca identificar prácticas prometedoras para el diseño y la implementación de CABs en el contexto de MassHealth. Basándose en un análisis de entorno, entrevistas con partes interesadas y conversaciones con los propios miembros de MassHealth, este informe delinea principios rectores o “north stars” [estrellas del norte] para establecer CABs. También detalla recomendaciones prácticas para diseñar y operar CABs eficaces.

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.

In 2023, the Foundation released a statewide Health Equity Action Plan, which proposed a vision and framework for achieving a racially and ethnically equitable health care delivery system in Massachusetts. To advance the Action Plan and as a step towards more coordination and cross-system learning among Massachusetts stakeholders, the Foundation, in collaboration with Manatt Health, developed the Massachusetts Health Equity Initiative Inventory and accompanying brief explainer. The Inventory is an interactive resource in Microsoft Excel that contains over 140 interventions and programs being implemented to address racial, ethnic, and linguistic inequities in Massachusetts’ health care delivery system. Each initiative featured in the Inventory includes a brief description and information on outcomes, where available. Users can sort initiatives by various categories, including:

• clinical area of focus, 
• population, 
• geographic region, 
• funding source, and 
• type of implementing entity.

The Inventory was developed as a tool for organizations across the health care delivery system in Massachusetts looking to start or advance their health equity work, offering examples and promising practices of initiatives across various areas of focus. It can also be used by other stakeholders, including state agencies, policymakers, and funders to inform programmatic and funding priorities. 

As organizations adopt and update their health equity initiatives, the Foundation will periodically update the Inventory and will keep the most up-to-date version on its website. If you would like to submit an initiative or update information related to an existing initiative, you can do so via this form.

On Tuesday, December 3rd, 2024, the Foundation hosted a webinar on the Inventory. During the webinar the speakers discussed the impetus for the Inventory, shared key takeaways and lessons learned from compiling this resource, and highlighted how it may be used by organizations in various phases of their health equity journey. The webinar also featured a demonstration of how to use this interactive tool. Click here to access a recording of the webinar and a copy of the webinar slides.

MassHealth provides health care services to over 2 million Massachusetts residents. This updated infographic highlights key facts about MassHealth, including the many ways in which the program contributes to the Massachusetts economy and promotes health care coverage and access for residents in the state.

Are you interested in learning more about the MassHealth program? Were you unable to attend our November 2024 webinar on MassHealth: The Basics? If so, join us on Wednesday, February 5th, from 12:00 - 1:00 PM for a webinar to review key facts and data about MassHealth eligibility, benefits and delivery systems, costs, and recent reforms from our October 2024 edition of the MassHealth: The Basics – Facts and Trends chart pack. The goal of the webinar is to provide participants with basic background information about MassHealth, including what benefits MassHealth covers, who it serves, program spending, and a status update on the state’s latest delivery reform efforts. Click here to register for the webinar. NOTE: This webinar will cover the same content as our November 2024 webinar on MassHealth: The Basics.

This chart pack describes the potential threats to subsidized health insurance coverage and financing in Massachusetts under the new federal administration. The goals of this chart pack are to:

• Provide a high-level overview of MassHealth, the Health Connector, and publicly subsidized health insurance programs in Massachusetts that could be impacted by federal policy changes.
• Describe the potential changes in federal financing and policy related to Medicaid and subsidized Affordable Care Act Marketplace coverage programs that are likely being considered by the new federal administration.
• Provide estimates of the potential impacts of these changes (in terms of dollars or lives) for MassHealth and Massachusetts ConnectorCare programs.
• Identify, to the extent possible, the timing, political hurdles, and implementation vehicles for these potential changes.

On March 20, 2025, the Foundation hosted a webinar that featured a presentation of the chart pack’s content by its authors from Manatt Health. Click here to view a recording of this webinar.

A well-functioning health care system should provide affordable and timely access to needed health care for all residents, without regard to their race, ethnicity, income, zip code, age, gender, or sexual orientation. The Massachusetts health care system, despite many exemplary qualities, does not do this, and recent access, affordability, and equity challenges for individuals and certain population groups, such as people of color, have highlighted the shortcomings of a system that is determined largely by market forces and the decisions of private entities. Given the pressures on the current system, there is a renewed interest in exploring how the process of state health planning can improve the allocation of health care resources in service to access, quality, and affordability.

This issue brief offers background on health services planning, describing the concept and outlining its history, including its rise and fall in the United States and in Massachusetts. The bulk of the brief is a catalog of the regulatory and policy tools that Massachusetts uses today that incorporate some aspects of health services planning, and how these tools do and do not interact. The brief concludes with a discussion of the gaps Massachusetts needs to fill to realize a complete, comprehensive health services planning initiative.

The Foundation is hosting a webinar on Wednesday, May 28th from 11:00 AM – 12:00 PM with author, Robert Seifert, who will review key findings from the brief, which is intended to lay the groundwork for future research and analysis on state health planning. The webinar will also feature remarks from the Massachusetts Health Policy Commission focused on the recently enacted law that established the Office of Health Resource Planning, which as the name suggests, has a clear health planning mandate. Click here to register for the webinar.