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
Pages
