Massachusetts

Integrated Care Activities

Financial Alignment DemonstrationCapitated model
Dual Eligible Special Needs Plan ContractingYes
Medicaid Managed Long-Term Services and Supports ProgramYes
Approved Medicaid Health HomeNo
Program of All-Inclusive Care for the Elderly (PACE)Yes

blacktriangle CMS Medicare-Medicaid Enrollee State Profile: Massachusetts - 2008. Provides demographic, enrollment, and expenditure data.


Financial Alignment Demonstration Resources

blacktriangle Experiences with Financial Alignment Initiative Demonstration Projects in Three States: Feedback from Enrollees in California, Massachusetts, and Ohio (MACPAC/May 2015) This report describes beneficiary experiences with enrollment processes, communication about the model of care, and understanding of care coordination services under the capitated model financial alignment demonstrations.

blacktriangle One Care Videos (MACPAC/May 2015) (Massachusetts Executive Office of Health and Human Services) In these videos, consumers enrolled in the One Care demonstration describe how the program has benefitted them.

blacktriangle Key Demonstration Documents on the MMCO Website (proposal, three-way contract, readiness review tool, evaluation design plan, etc.) and State Website.

blacktriangle Early Insights from One Care: Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries (Kaiser Family Foundation/May 2015) This case study describes the early implementation of Massachusetts’ capitated financial alignment demonstration.

blacktriangle Massachusetts One Care Initiative for Non-elderly Dual Eligibles (Massachusetts Medicaid Policy Institute/April 2014) This fact sheet provides a comprehensive description of One Care, Massachusetts’ demonstration project for adults with disabilities between the ages of 21 and 64 who are dually eligible for Medicare and Medicaid.

blacktriangle Massachusetts’ Demonstration to Integrate Care and Align Financing for Dual Eligible Beneficiaries (Kaiser Family Foundation/October 2012) This policy brief summarizes the terms of Massachusetts’ MOU in the several key areas, including enrollment, care delivery model, benefits, financing, beneficiary protections and monitoring and evaluation.

blacktriangle Massachusetts Proposed Demonstration to Integrate Care for Dual Eligibles. This brief examines Massachusetts' proposal to CMS to create an integrated service delivery and payment model in that state.

blacktriangle MassHealth Senior Care Options – Contract for Senior Care Organization. This contract contains language useful to states developing three-way contracts for a duals demonstration or a capitated financial model demonstration. Note, this is provided for informational purposes and is not necessarily a template for three-way contracts. Basic Contract.  Amendment #1 2010.  Appendices 2009.

blacktriangle Request for Responses from Integrated Care Organizations. This document solicits proposals from Integrated Care Organizations (ICOs) to participate in Massachusetts’ demonstration program.

blacktriangle Risk Adjustment for Dual Eligibles: Breaking New Ground in Massachusetts. This report offers recommendations for developing risk adjustment and rate-setting mechanisms to reinforce the goals of care integration.