Integrating MassHealth LTSS: Considerations for ACOs and MCOs

Prepared for Blue Cross Blue Shield of Massachusetts Foundation

Massachusetts and the nation as a whole are beginning to grapple with how to improve access to quality care for individuals who require long-term service and supports (LTSS) while simultaneously containing costs. In November 2016, the Centers for Medicare and Medicaid Services (CMS) approved a Section 1115 waiver extension request for MassHealth to implement program-wide delivery system and payment reforms over the next five years through the creation of a Medicaid Accountable Care Organization (ACO)–based delivery system that will work in partnership with the state’s existing managed care organization (MCO) infrastructure.

Manatt Health authored an issue brief for Blue Cross Blue Shield of Massachusetts (BCBSMA) Foundation that prioritizes issues for consideration as ACOs and MCOs prepare to integrate and fully manage comprehensive LTSS over the course of Massachusetts’ five-year 1115 waiver extension. The identified priority areas were informed by lessons learned from managed LTSS programs in other states and interviews with key stakeholders in Massachusetts.

The brief concludes with a series of detailed descriptions of the institutional and community LTSS covered under the Medicaid state plan that will eventually be integrated into ACOs and MCOs.

Click here to read the full BCBSMA Foundation report.

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