6 Massachusetts health networks test ACO pilot program for Medicaid

Six Massachusetts health systems are launching programs Thursday that will change the way they are paid for care provided to 160,000 Medicaid recipients, according to The Boston Globe

CMS approved a five-year, $52.5 billion Medicaid waiver for Massachusetts in early November. Massachusetts is one of several states with a Medicaid waiver from the federal government. The waiver allows Massachusetts to retool MassHealth, its Medicaid program.

The overhaul of MassHealth involves shifting from fee-for-service to a value-based model, including the launch of an ACO pilot program and investments in long-term care services and behavioral health.

Under the ACO pilot program, health systems will be rewarded for efficiently providing high-quality care to Medicaid patients. If a system spends less than its set budget for care for its Medicaid population, it will share in some of the savings achieved. A system is responsible for some of the losses if it exceeds the budget, according to the report.

On Thursday, the following five hospitals and health systems will launch the ACO pilot program: Boston-based Partners HealthCare, Boston-based Steward Health Care System, Worcester-based University of Massachusetts Memorial Health Care, Boston Medical Center and Boston Children's Hospital. A network of community health centers called Community Care Cooperative will also participate in the program, according to the report.

"ACOs will work closely with community-based health organizations to better integrate care for behavioral health, long-term services and supports, and health-related social needs," Marylou Sudders, secretary of Massachusetts Health and Human Services, said in a statement to The Boston Globe. "We look forward to learning from this one-year pilot as we restructure the Medicaid program."

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