Massachusetts officials are planning a big overhaul of the state's Medicaid program as they try to rein in soaring costs, according to a Boston Globe report.
Here are eight things to know about the issue.
1. The state's Medicaid program, called MassHealth, provides health coverage to about 1.8 million low-income people.
2. Massachusetts officials said the costs of MassHealth, which accounts for 40 percent of the state budget, will continue to grow faster than state revenues, squeezing out other important programs, unless significant changes are made, according to the report.
3. Under the state's proposal, MassHealth would no longer be a system that is predominantly fee-for-service. Instead, the officials want to more widely implement a value-based care model, in which physicians and hospitals are paid set budgets to treat patients, according to the report.
4. The idea with the overhaul, the Boston Globe notes, is to compensate healthcare providers to coordinate care for patients, which could help eliminate waste and unnecessary hospital visits that contribute to soaring costs.
5. "By restructuring, we can improve the member experience, and hopefully be more efficient in order to start to bend the cost trend," Marylou Sudders, the state's health and human services secretary, told the Boston Globe. "If not, we will look at having to reduce benefit programs."
6. Under the state's proposal, physicians and hospital systems would also be able to create accountable care organizations and contract directly with MassHealth, according to the report. The state's ultimate goal is to move the majority of MassHealth members into such models.
7. The state's proposed overhaul of MassHealth, scheduled to begin in October 2017, is dependent on federal funding, the report notes. According to the Boston Globe, state officials want an agreement with federal officials for five years of funding, including $1.5 billion in new payments to help the state transition to accountable care.