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Budget Summary FY2018

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40000500 - MassHealth Managed Care
Data Current as of:  12/6/2017

Account Description FY2017
4000-0500 MassHealth Managed Care
For health care services provided to medical assistance recipients through the executive office of health and human services' managed care delivery systems, including a behavioral health contractor, the Primary Care Clinician Plan, Primary Care Accountable Care Organizations, MassHealth managed care organizations and Accountable Care Partnership Plans and for MassHealth benefits provided to children, adolescents and adults under section 9 of chapter 118E of the General Laws and clauses (a) to (d), inclusive, and clause (h) of subsection (2) of section 9A of said chapter 118E and section 16C of said chapter 118E; provided, that no funds shall be expended from this item for children and adolescents under clause (c) of said subsection (2) of said section 9A of said chapter 118E whose family incomes, as determined by the executive office, exceed 150 per cent of the federal poverty level; provided further, that funds may be expended for infrastructure and capacity building grants to promote delivery system reform, achieve federal financial participation and serve populations in need more efficiently and effectively; provided further, that of said funds, funds may be expended for community health centers; provided further, that the executive office shall maximize federal reimbursements for state expenditures made to these providers provided further, that expenditures from this item shall be made only for the purposes expressly stated in this item; provided further, that not later than March 15, 2018, the executive office shall submit a report to the house and senate committees on ways and means detailing: (i) the outcomes achieved by accountable care organizations and community partners including, but not limited to, financial performance, patient satisfaction and quality and aggregate and per-member reductions in spending off of cost trends; (ii) the results of benchmarks on accountable care organizations' and community partners' progress toward an integrated care delivery system; and (iii) the projected and to date cost effectiveness of spending on traditionally non-reimbursed flexible services to address health-related social needs including, but not limited to, housing stabilization and support, utility assistance, non-medical transportation, physical activity and nutrition, and sexual assault and domestic violence supports; and provided further, that funds may be expended from this item for health care services provided to recipients in prior fiscal years
5,312,397,476 5,553,251,863