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 

Steward Health Care System - CMS Pioneer ACO

Steward Health Care System is a community-based accountable care organization and community hospital network with more than 17,000 employees serving more than one million patients annually in more than 150 communities.

Partners HealthCare - CMS Pioneer ACO

Partners HealthCare was selected to participate in the Pioneer Accountable Care Organization (ACO) model in December of 2011.  The initiative, sponsored by the Centers for Medicare & Medicaid Services (CMS) Innovation Center, aims to transform the way that health care is delivered by providing Medicare patients with higher quality, while slowing cost growth through enhanced care coordination. The Pioneer ACO Model is designed to encourage the development of accountable ca

Mount Auburn Cambridge Independent Practice Association (MACIPIA) - CMS Pioneer ACO

The CMS Pioneer ACO initiative encourages primary care doctors, specialists, hospitals and other health care providers to better coordinate care for patients on Medicare. MACIPA’s Care Managers and Care Coordinators work closely with physicians to provide additional individualized support for patients who are hospitalized, in a skilled nursing or rehabilitation facility, and for the chronically ill and frailest patients living in their homes. Care coordinators are Registered Nurses who work with physicians to facilitate and coordinate the patient’s discharge from the hospital.

Beth Israel Deaconess Physician Organization - CMS Pioneer ACO

Beth Israel Deaconess Physician Organization (BIDPO), which has more than 1,600 providers and is the physician organization affiliated with Beth Israel Deaconess Medical Center, was selected based in part on its experience in working with global payment models.

Atrius Health - CMS Pioneer ACO

Through the Pioneer ACO Model, Atrius Health will work with CMS to provide Medicare beneficiaries with higher quality care, while reducing growth in Medicare expenditures through enhanced care coordination. The Pioneer ACO Model is designed to encourage the development of ACOs, which are groups of doctors and other healthcare providers who work together to provide high quality care for their patients.

Building a Health-Care Home

on mar, 2013-10-01 00:00   lisabeth
One patient, many providers— and a fresh approach to bringing it all together

The dentist eyes her patient’s red, spongy gums. she knows he was diagnosed some years ago with Type 2 diabetes, and now the condition of his mouth tells her that his blood-glucose levels are likely not as well-controlled as they should be.

Story Date: 
October 1, 2013
News Author: 
Helene Ragovin
Source Link: 
Read More

PCORI Funding Award - Brigham and Women's Hospital

Brigham and Women's Hospital (BWH) was selected to receive a research award from the Patient-Centered Outcomes Research Institute (PCORI) in 2013 to study the benefits of new models for delivering transitional care from the hospital to home within an Accountable Care Organization structure. The project, titled "Relative benefits of a hospital-PCMH collaboration within an ACO to improve care transitions," is part of a portfolio of patient-centered comparative clinical effectiveness research that addresse

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