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On October 18, 2019, Governor Charlie Baker submitted House Bill 4134, An Act to Improve Health Care by Investing in Value, to the Massachusetts Legislature. The bill proposes a comprehensive set of policies designed to address barriers to behavioral health care access, including the establishment of a new system that would incentivize providers and health plans to spend more of their funds on primary care and behavioral health services while rebalancing spending in other areas.

Texas v. United States, a case currently before the U.S. Court of Appeals for the Fifth Circuit, seeks to overturn the Affordable Care Act (ACA). The court’s decision in the case could be announced any day and the case may ultimately be decided by the Supreme Court. A final ruling that overturns the ACA would have widespread implications, affecting every state in the nation.

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 brief and accompanying set of tables serve as an update to previously released reports on the geography of uninsurance in Massachusetts. Relying on newly released data for 2013-2017 from the American Community Survey (ACS), this brief uses three measures of uninsurance – uninsurance rate, number of uninsured, and concentration of uninsured – to identify high-uninsurance communities in the state.

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.

In January 2016, the Blue Cross Blue Shield of Massachusetts Foundation undertook a three-year grant-funded initiative to expand access to integrated behavioral health (IBH) and primary care services in Massachusetts – Fostering Effective Integration (FEI). Grants were awarded to a diverse cohort of eight providers in the Commonwealth with experience in delivering IBH care. This report describes the findings of an evaluation conducted by John Snow, Inc. (JSI) from January 2016 to December 2018.

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.

This report and companion chart pack document and describe the current behavioral health (inclusive of mental health and substance use disorder) care system for children, adolescents, and adults in Massachusetts; outline a new whole-person-oriented vision for behavioral health care in the Commonwealth; and propose a strategic approach and series of recommendations through which the state can advance this vision to achieve reform.

This collection of materials is the latest in a series by the Urban Institute summarizing the findings from the 2018 Massachusetts Health Reform Survey (MHRS). The Foundation began conducting the MHRS in fall 2006 to support the evaluation of Massachusetts’ 2006 health care reform bill. The survey has been fielded periodically since 2006 – most recently in spring 2018 – to monitor key measures pertaining to health insurance coverage and health care access and affordability among non-elderly adults (ages 19-64) in Massachusetts.

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.

In Massachusetts, MassHealth is implementing a number of reforms as part of its most recent Medicaid 1115 demonstration waiver extension to transform the delivery of care for most members and address the social determinants of health (SDOH). In light of the new interface between health care and social service delivery fostered by the MassHealth program redesign, it is important to understand how community-based organizations (CBOs) perceive the entry of health care organizations into their domains of social service delivery.

This report seeks to inform the discussion of MassHealth sustainability through a novel analysis of MassHealth data that differentiates among the major drivers of MassHealth spending. The report examines whether spending is being driven by growth in enrollment or per-enrollee spending, and which populations or types of services are the biggest contributors to spending growth.