Massachusetts

As a leader in health care reform and innovation, Massachusetts is dedicated to transforming its payment and delivery systems to transition away from FFS to a system of value-based purchasing stragtegies. MassHealth, the state Medicaid program, is expanding value-based purchasing strategies for Managed Care Organizations and aims to expand this initiative to include global payments by MCOs to integrated care organizations and other integrated providers, and transition primary care provider payment methodologies into alignment with Patient-Centered Medical Homes. 

In 2012, Massachusetts enacted Chapter 224 of the Acts of 2012 to slow the growth in state health care costs, improve quality of care and patient outcomes, and increase transparency and oversight of provider and payer price and cost data. The law builds on the momentum in the private market by providing for the development of processes for the certification of organizations as accountable care organizations and patient centered medical homes. In addition, the law creates a “Model ACO” program through which organizations can be designated as “Model ACOs” and receive priority from MassHealth, the Group Insurance Commission, and the Health Connector.

 

CHIPRA: 
Yes
MAPCP: 
No
Dual Eligible: 
Yes
2703 Health Home: 
No
CPCi: 
No
SIM Awards: 
Yes
PCMH in QHP: 
No
Legislative PCMH Initiative: 
Yes
Private Payer Program: 
Yes
State Facts: 
Population:
6,595,300
Uninsured Population:
4%
Total Medicaid Spending FY 2013: 
$13.2 Billion 
Overweight/Obese Adults:
58.0%
Poor Mental Health among Adults: 
35.8%
Medicaid Expansion: 
Yes 

H. 1250 An Act to Improve Health Equity

This broad health equity bill includes provisions requiring the Massachusetts Health Policy Commission to establish targets for primary care and behavioral health spending targets and provide analyses of progress toward those targets.

Section 19, Chapter 224, Acts of 2012

Establishes a Center for Health Information and Analysis (CHIA) charged with a range of duties, incuding analyzing health costs and utilization in the Massachusetts. On September 20, 2022, CHIA subsequently released the first report on primary care and behavioral health spending in Massachusetts.

S. 750

S. 750 would establish a multistakeholder Primary Care Board with a goal of increasing primary care spend to 12-15% of overall health care expenditures. The bill would also require all insurers in the state to offer a prospective, per member per month Primary Care 4 You payment to all primary care practices.  The payment would be adjusted for clinical and social risk and practice capacity. Monthly prospective payments would be paid from a Primary Care Trust, rather than individual plans.

S. 770

For the 3-year period ending with calendar year 2024, the aggregate primary care expenditure target for each of the 3 years shall be equal to a 30 per cent increase above aggregate primary care baseline expenditures, and the primary care expenditure target for each of the 3 years shall be equal to a 30 per cent increase above primary care baseline expenditures.

S.2774

Providers and insurers, including MassHealth, will be required to increase spending on behavioral health and primary care by 30% over three years.

Safest States During COVID-19

WalletHub study

As the U.S. continues its efforts to overcome the COVID-19 pandemic amid a surge in cases caused by variant strains, staying safe is one of Americans’ top concerns. Safety is also essential for getting the economy back on track, as the lower COVID-19 transmission and deaths are in a state, the fewer restrictions there will be and the more confidence people will have to shop in person. While almost all states have fully reopened, we’ll only be able to completely get back to life as normal once most of the population is fully vaccinated against coronavirus. The good news is that the U.S.

News Author: 
Adam McCann

Massachusetts task force calls for creation of statewide equity office and equity-focused review of response to COVID-19

A task force of state lawmakers and health experts called on the Legislature to create a statewide office and a Cabinet-level position focused on equity, and to immediately initiate an equity-focused review of the state’s response to COVID-19 in its final report released Thursday.

News Author: 
Camille Caldera

New England States Issue Regional PC Spend Report

A consortium of New England States, known as NESCSO, recently released a first-of-its-kind regional report on levels of primary care investment across six states.

Baker pushes for more emphasis on primary care, mental health

At the heart of his biggest health care initiative as governor, Charlie Baker is proposing a fundamental shift in how Massachusetts delivers care.

Lessons learned: What patients said about their experience in primary care practices

What makes a good doctor? Just ask their patients.

Based on a new survey, it becomes clear that good communication with their physicians, as well as with other clinicians, is key to a positive patient experience.

News Author: 
Joanne Finnegan

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