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Global Payments to Improve Quality and Efficiency in Medicaid
Monday, November 16, 2009
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.
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Medicaid Prescription Drug Quality and Cost Management: Options, Opportunities and Progress
Friday, November 13, 2009
On November 13, 2009, MMPI partnered with the Massachusetts Health Policy Forum and Community Catalyst to sponsor a forum exploring efforts in Massachusetts to improve quality and control Medicaid prescription drug costs. At the forum, an issue brief was released that detailed implementation of a preferred drug list in the MassHealth program. In addition, speakers talked about the array of tools available to states to improve prescribing and reduce cost growth.
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The MassHealth Waiver: 2009-2011 ... and Beyond
Saturday, February 28, 2009
On December 22, 2008, the Centers for Medicare and Medicaid Services approved Massachusetts’ request to renew the MassHealth Section 1115 Research and Demonstration Waiver (Waiver) for an additional three years, through the end of state fiscal year 2011. The Waiver, which has been in place since 1997, authorizes critical federal funding for several health coverage programs for low-income individuals and for the Commonwealth’s safety net health system for uninsured residents. It is the programmatic and financial underpinning of the state's health care reform law. Through the Waiver, over 1 million low-income children, families and individuals receive coverage through MassHealth and Commonwealth Care, the subsidized premium assistance program for low-income adults created by Chapter 58. This report explains how the state's Waiver works.
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Massachusetts Medicaid in Perspective: An Analysis of Spending Growth and Economic Growth, 1996-2007
Sunday, September 28, 2008
This issue brief updates "MassHealth and State Fiscal Health: A New Look at the Effects of Medicaid Spending on State Finances," through 2007.
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The Basics of the Massachusetts Medicaid Program
Thursday, September 25, 2008
A fact sheet that introduces MassHealth, the Massachusetts Medicaid program, describing its basic structure, benefits and beneficiaries. It examines how enrollment and spending have changed over time and describes some current policy issues and challenges.
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Pathways to Public Health Insurance Coverage for Massachusetts Residents
Sunday, November 25, 2007
An easy-to-use guide describing public health insurance options in Massachusetts and a set of flow charts illustrating the eligibility pathways to these programs for low-income people and families, elderly people, and people with disabilities. Also available on the Pathways to Coverage website.
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Implementing the Rosie D. Remedy: The Opportunities and Challenges of Restructuring a System of Care for Children's Mental Health in Massachusetts
Thursday, October 25, 2007
The district court ruling in Rosie D. v. Romney, and the subsequent remedy now being implemented by state health and human service agencies, have the potential to transform the delivery of mental health services for children with serious emotional disturbances in Massachusetts. This issue brief explores the implications and potential effects of the case and the resulting remedy on the MassHealth program, other state programs, the behavioral health and social service delivery systems, and affected children and their families.
Presentation slides from October 12, 2007 MMPI forum on Rosie D. and children's mental health:
- Holly Kenny, author of MMPI's Rosie D. paper: View Slides (PDF)
- Emily Sherwood, Director of Children's Behavioral Health Interagency Initiatives, Executive Office of Health and Human Services: View Slides (PDF)
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Pay-for-Performance to Reduce Racial and Ethnic Disparities in Health Care in the Massachusetts Medicaid Program
Wednesday, July 25, 2007
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. The Roundtable’s recommendations are detailed in this white paper.
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Medicare Part D: Successes and Continuing Challenges
Friday, May 25, 2007
The creation and implementation of the Medicare prescription drug benefit — “Part D” — attracted wide national attention and controversy. This paper, produced in collaboration with the Massachusetts Health Policy Forum, looks beyond the anecdotes and gives a progress report on the impact of Part D in Massachusetts for Medicare beneficiaries — 200,000 of whom are also MassHealth members — and for state health programs such as MassHealth and Prescription Advantage.
Download the presentation slides by Cindy Parks Thomas from May 30, 2007 forum (PDF)
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The State Children's Health Insurance Program in Massachusetts: Achievements, Challenges, and Implications for Health Reform
Tuesday, May 01, 2007
The issue brief examines how SCHIP is part of the Commonwealth’s universal coverage strategy; how SCHIP is funded in Massachusetts; and the funding shortfalls the program now faces. The brief also details how the SCHIP program and funding are integrated with MassHealth, and the implications of that connection for the upcoming negotiations to extend the MassHealth waiver.
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The Outlook for Medicaid in Massachusetts
Monday, March 26, 2007
This report examines some of the important issues, opportunities and challenges facing the MassHealth program at the outset of a new Governor's administration including renewal of the the MassHealth waiver, improving the value of MassHealth purchasing, rebalancing long-term care, and providing strong leadership and bolstering staff.
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The MassHealth Waiver: An Update
Tuesday, September 26, 2006
This issue brief looks at the terms and conditions of the MassHealth Waiver, approved in July 2006, that will run through FY 2008. The July 2006 Waiver approval incorporates the provisions of the health reform law, which enacted some of the changes required in the initial approval of this Waiver renewal, in January 2005. MMPI produced an analysis of the initial approval last year; this brief updates the earlier one to reflect the terms of the Waiver as they now stand.
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MassHealth and State Fiscal Health: A New Look at the Effects of Medicaid Spending on State Finances
Monday, June 26, 2006
This report from MMPI and the Massachusetts Budget and Policy Center looks at Medicaid spending in relation not only to total public spending, but also to state revenues and overall economic growth. It concludes that, between Fiscal Years 1994 and 2005, Medicaid spending changed very little in relation to the economy as a whole, and therefore was sustainable given the economic growth over that same period. Looking at Medicaid spending with this broader view provides a new context for policy makers as they think about the Medicaid budget, now and in the future.
Click here for a 2-page fact sheet
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The Role of MassHealth “Budget Neutrality” Requirements in Designing Policies to Expand Health Coverage
Monday, June 05, 2006
This issue brief reviews the concept of budget neutrality and, within its constraints, the options available to maximize federal dollars for coverage of the uninsured.
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The MassHealth Waiver
Sunday, June 26, 2005
In 2005, Massachusetts renegotiated with the federal government major provisions of the State’s Medicaid program governed by the MassHealth Waiver, which has been in effect since 1997. The new terms of the Waiver, which became effective July 1, 2005, are significantly different from the current terms, particularly in the details of how the program is financed. This issue brief describes the most significant changes in the Waiver agreement and identifies the major issues involved with state implementation.
Download the presentation from the April 11, 2005 forum on the MassHealth Waiver (PDF)
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MassHealth: It’s Good for Business - Ten Facts the Employer Community Should Know About the Massachusetts Medicaid Program
Sunday, June 26, 2005
This report provides new perspectives about the importance of MassHealth for the state’s business community and, in particular, explains how a strong MassHealth program benefits employers. MassHealth is a major source of health insurance for low-wage workers, covering more than 400,000 employed people and their families. It is a major reason why Massachusetts has a relatively low percentage of people without insurance, and program expansions have helped reduce the costs of uncompensated care, which is financed in part by the business community. Adequate funding for MassHealth also helps minimize provider cost-shifting to employers.
Download Executive Summary (PDF)
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Eligible but Uninsured: Challenges to Getting and Keeping MassHealth
Thursday, May 26, 2005
As many as 106,000 of the State’s 460,000 uninsured residents could be eligible for MassHealth coverage. The Massachusetts Medicaid Policy Institute’s new issue brief – Eligible but Uninsured: Challenges to Getting and Keeping MassHealth – describes current initiatives to enroll the eligible uninsured and examines some of the barriers Massachusetts residents face to getting and retaining MassHealth benefits.
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MMPI Budget Bulletin: The FY 2006 Massachusetts Medicaid Program Budget
Thursday, May 05, 2005
MMPI’s 2006 budget bulletin contains highlights of the Senate Ways & Means Committee’s MassHealth budget, and includes links to more detailed analyses. You may also read our past bulletins on the Governor’s and House budget proposals.
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The New Medicare Prescription Drug Law: Implications for State Health Plans in Massachusetts
Sunday, September 26, 2004
The Medicare Prescription Drug Improvement and Modernization Act of 2003 created a new drug benefit for Medicare recipients, which began in 2006. The new law had significant effects on the Massachusetts Medicaid program, which at the time provided prescription drug and other benefits to about 190,000 Medicare beneficiaries. This policy brief identifies the key factors affecting the interaction between Medicare and Medicaid and describes the impacts – financial, programmatic and administrative – of the new drug benefit on the Medicaid program in Massachusetts.
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MMPI Budget Bulletin: The FY 2005 Massachusetts Medicaid Program Budget
Saturday, June 26, 2004
Following are highlights of the FY2005 budget that concern the Commonwealth’s Medicaid program, known as MassHealth.
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Understanding MassHealth Members with Disabilities
Saturday, June 26, 2004
Non-elderly people with disabilities comprise one-fifth of MassHealth enrollment and an even larger share of expenditures, yet their circumstances and the crucial role of Medicaid in financing essential services for them are not well understood. This comprehensive report seeks to promote such understanding and support informed policy discussions about this group.