Payment Reform

Value-Based Payment to Support Children’s Health and Wellness: Shifting the Focus from Short-Term to Life Course Impact

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.

Cover of the Value-Based Payment to Support Children's Health and Wellness
Cover of the Value-Based Payment to Support Children's Health and Wellness

Chapter 224 Tracking Tool, Updated November 2017

The fourth edition of the 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 as of November 2017. This tool is designed for policymakers, advocates, and other stakeholders who wish to track when and how state leaders have addressed policy issues pertaining to Chapter 224.

10 Years of Impact: A Literature Review of Chapter 58 of the Acts of 2006

Chapter 58 of the Acts of 2006—“An Act Providing Access To Affordable, Quality, Accountable Health Care”—was signed into law by Governor Mitt Romney on April 12, 2006. The groundbreaking law sought near-universal health care coverage for the residents of Massachusetts by expanding Medicaid, creating a new program of subsidized insurance, enacting changes to the health insurance market, and requiring adults to have health insurance unless an affordable option was not available.

Chapter 224 Tracking Tool, Updated August 2015

This updated edition of the 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 as of August 2015. This tool is designed for policymakers, advocates, and other stakeholders who wish to track when and how state leaders have addressed policy issues pertaining to Chapter 224.

Coverage Options for Massachusetts: Leveraging the Affordable Care Act

In this issue brief, Patricia Boozang, Deborah Bachrach and Hailey Davis of Manatt Health Solutions, review the coverage and delivery system challenges that Massachusetts could address through sections 1331 (the Basic Health Program) and 1332 (Waivers for State Innovation) of the Affordable Care Act (ACA).

Paths to Sustainability for Innovative Delivery System Programs

Peter Hussey, Courtney Armstrong, and Eric Schneider of the RAND Corporation conducted interviews with seven health plans and five Accountable Care Organizations (ACOs) to determine their support for innovative delivery system models including payment arrangements, program development strategies, and the criteria decide whether or not to support these programs.

Alternative Payment Models and the Case of Safety-Net Providers in Massachusetts

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.

Chapter 224 Tracking Tool

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.

Chapter 224: What Does It Mean for Hospitals, Health Plans, Consumers, and Clinicians?

These fact sheets highlight the major implications of Massachusetts’s 2012 health care cost containment law, Chapter 224, for four key stakeholder groups:  hospitals, health plans, consumers, and clinicians. From increased data reporting requirements for hospitals and health plans, to greater cost transparency for consumers, Chapter 224 will have significant impacts on many aspects of the Massachusetts health care system in the years ahead.

Chapter 224 of the Acts of 2012: Implications for MassHealth

This report, written by Robert Seifert and Rachel Gershon of the Center for Health Law and Economics at UMass Medical School, examines the key components of the most recent Massachusetts health reform law - Chapter 224 of the Acts of 2012 - as they pertain to the Massachusetts Medicaid program (“MassHealth”). Under the new law, MassHealth will be subject to the annual spending growth benchmark and will be required to implement alternative payment arrangements for most of its members, among other new requirements and responsibilities.

Summary of Chapter 224 of the Acts of 2012

This report – written by Anna Gosline and Elisabeth Rodman of the Blue Cross Blue Shield of Massachusetts Foundation – summarizes the key components of Chapter 224 of the Acts of 2012, “An Act Improving the Quality of Health Care and Reducing Costs Through Increased Transparency, Efficiency and Innovation,” which was signed into law on August 6, 2012.

Innovations in Medicaid: Considerations for MassHealth

Report summarizing the results of a series of interviews conducted by the Center for Health Care Strategies with key Medicaid stakeholders from across the country on cutting-edge Medicaid strategies including: purchasing strategies to optimize delivery systems; payment strategies to leverage existing funds; integrated models of care to improve services for complex populations; and opportunities for improved organizational capacity.

Beyond Parity: Mental Health and Substance Use Disorder under Payment and Delivery System Reform in Massachusetts

This report by Colleen Barry of the Johns Hopkins Bloomberg School of Public Health explores opportunities and issues around integrating behavioral health care and primary care under the Affordable Care Act (ACA) and payment and delivery system reforms in Massachusetts. The report provides preliminary recommendations on how these major policy changes might be implemented with the goal of improving the coordination, quality and outcomes of mental health and addiction care in the Commonwealth.

Global Payments to Improve Quality and Efficiency in Medicaid

MassHealth, the Massachusetts Medicaid program, could play a leading role in implementing dramatic changes to the health care payment system. This report outlines how so-called global payments could be used in MassHealth, which provides insurance coverage to roughly 1.2 million people in the state. Global payments have been recommended by both the Special Commission on Health System Payment and the Massachusetts Health Care Quality and Cost Council as a means of reigning in health care cost increases and improving care coordination.

Pay-for-Performance to Reduce Racial and Ethnic Disparities in Health Care in the Massachusetts Medicaid Program

The 2006 Massachusetts health care reform law included a provision to make Medicaid hospital rate increases contingent upon quality measures, including measures of the reduction of racial and ethnic disparities. To date, no other pay-for-performance programs have incorporated measures of the reduction of racial and ethnic disparities into their incentives. MMPI organized the Massachusetts Medicaid Disparities Policy Roundtable to bring together a group of experts to develop and recommend an approach to implementing the program.