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40000500 - MassHealth Managed Care
Data Current as of: 8/10/2018
Account | Description | FY2018 Spending |
FY2019 GAA |
---|---|---|---|
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 household incomes, as determined by the executive office, exceed 150 per cent of the federal poverty level; provided further, that not later than March 15, 2019 the executive office shall submit a report to the house and senate committees on ways and means detailing: (a) total number of members participating in the ACO program; (b) disenrollment trends from the Partnership Plan, Primary Care ACO, and MCO-administered Accountable Care Organizations within the designated plan selection; (c) the outcomes achieved by accountable care organizations and community partners including, but not limited to, financial performance, patient safety, patient satisfaction and quality and aggregate and per-member reductions in spending compared to prior cost trends; (d) the results of benchmarks on accountable care organizations' and community partners' progress toward an integrated care delivery system; and (e) a summary of spending and activities related to traditionally nonreimbursed services to address health-related social needs including, but not limited to, home and community-based services, housing stabilization and support, utility assistance, nonmedical transportation, physical activity, nutrition and sexual assault and domestic violence supports; provided further, that such summary shall include, to the maximum extent practicable, aggregated data on the results of preventative health care services such as health-related social needs screening, the number of referrals to human service providers to address such screening, the result of such referrals and changes in health status; provided further, that such data shall be stratified by demographic factors to support an analysis of the impact on health disparities; provided further, that where data is not available, a report on progress toward establishing necessary data systems shall be provided; (f) provided further, that said summary shall include outcome measures for at-risk populations with chronic health conditions; and provided further, that funds may be expended from this item for health care services provided to recipients in prior fiscal years |
5,338,456,687 | 5,759,010,341 |
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