Tag Archives: MA

Market Overview PDF

Download NowMassachusetts_071124.pdf

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MA Medicaid Managed Care Quality Strategy Reports, 2017-22

1. MassHealth Comprehensive Quality Strategy Report, June 2022
2. MassHealth Comprehensive Quality Strategy Report, November 2018
3. Medicaid Managed Care Quality Strategy Report, 2017
4. Behavioral Health Partnership EQR Report, 2017
5. MassHealth One Care EQR Report, 2017
6. Primary Care Clinician (PCC) Plan Technical Report, 2017
7. Senior Care Organizations EQR Report, 2017
8. Massachusetts Medicaid Managed Care Quality Strategy Report, 2013

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BayMark Health Services Acquires MA-based Opioid Treatment Provider

BayMark Health Services announced on June 23, 2020, that it has acquired Middlesex Recovery, an office-based opioid treatment provider with four locations in Massachusetts. Middlesex Recovery will continue to operate under its brand name. Read More

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MA Physician Practices Eye M&A Options, Closure Given Financial Strains Due to COVID-19

Modern Healthcare reported on June 10, 2020, that 30 percent of Massachusetts physician practices are considering closing down, with medical and procedural specialist groups the most likely to consider closing shop, according to a survey of more than 400 practices by the Massachusetts Health Policy Commission and the Massachusetts Chapter of the American College of Physicians. About 20 percent are considering consolidating with other practices, joining a health system, or selling their practice. Read More

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MLRs Average 94.6% at MA Medicaid MCOs, 2019 Data

Average medical loss ratio among six Massachusetts Medicaid plans was 94.6% in 2019. Per member per month premiums among the six plans averaged $561.43.

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MA SNP Membership at 59,133, Mar-20 Data

Massachusetts had 59,133 Special Needs Plan members as of March 2020.

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MA Non-Emergency Humans Service Transportation Broker Services RFR, Amendments, and Model Contract, Nov-19

1. Massachusetts Non-Emergency Humans Service Transportation NEMT Broker Services Request for Responses (RFR), Issued November 11, 2019
2. RFR Amendment 1, January 24, 2020
3. Model Contract, January 28, 2020
4. RFR Amendment 2, March 13, 2020
5. RFR Amendment 3, March 24, 2020
6. Restated RFR, April 17, 2020

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MA Medicaid Fee for Service vs. Managed Care Penetration, 2014-19

Total Medicaid enrollment in Massachusetts was nearly 1.6 million in 2019. About 65.7% of Medicaid beneficiaries were enrolled in a managed care plan. The remainder are in fee-for-service Medicaid. Total Medicaid expenditures in Massachusetts were $17.4 billion in 2019, with about 41% through managed care and the rest through fee-for-service.

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Section 1135 Waivers Are Now Approved in 34 States

On March 27, 2020, the Centers for Medicare & Medicaid Services (CMS) announced that it has approved section 1135 waivers for several additional states in response to COVID-19, bringing the total number of approved states to 34. The most recent additions include Colorado, Connecticut, Delaware, Hawaii, Idaho, Maryland, Massachusetts, Minnesota, New York, Pennsylvania, and Wyoming. The waivers give the states significant flexibility in how Medicaid services and funds are used to respond to COVID-19. Read More

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MA to Allow Pharmacists to Administer Opioid Medication Treatments Amid Shortage of Nurses

On March 18, 2020, the Massachusetts Executive Office of Health and Human Services issued an order allowing pharmacists and pharmacy interns to administer methadone and buprenorphine for the treatment of opioid use disorder. This order is a response to the shortage of nurses during the COVID-19 emergency. Read More

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