08.21.2017

Final Contracts Okayed for Sweeping MassHealth ACO Program

On Wednesday contracts for the MassHealth Accountable Care Organization (ACO) program were finalized between the state and 17 ACOs. The massive shift of the MassHealth program from fee-for-service to the ACO model is the most sweeping change to the MassHealth program in a generation.

The ACO program is the centerpiece of the state’s five-year Medicaid waiver that was approved by the federal government in November 2016.  Throughout that waiver process, and since its inking, MHA and the hospital community have been working with the state to work out the fine details of how the ACO model would work and how to minimize the significant uncertainty and risk for organizations participating in it.

The 17 ACOs are as follows:
1.       Atrius Health with Tufts Health Public Plans
2.       Baystate Health Care Alliance with Health New England
3.       Beth Israel Deaconess Care Organization with Tufts Health Public Plans
4.       Boston Accountable Care Organization with Boston Medical Center HealthNet Plan
5.       Cambridge Health Alliance with Tufts Health Public Plans
6.       Children's Hospital Integrated Care Organization with Tufts Health Public Plans
7.       Community Care Cooperative, an organization of 13 federally qualified health centers.
8.       Health Collaborative of the Berkshires with Fallon Community Health Plan
9.       Lahey Health
10.     Mercy Health Accountable Care Organization with Boston Medical Center HealthNet Plan
11.     Merrimack Valley ACO with Neighborhood Health Plan
12.     Partners HealthCare ACO
13.     Reliant Medical Group with Fallon Community Health Plan
14.     Signature Healthcare Corporation with Boston Medical Center HealthNet Plan
15.     Southcoast Health Network with Boston Medical Center HealthNet Plan
16.     Steward Medicaid Care Network
17.     Wellforce with Fallon Community Health Plan.

This week, the UMass Memorial Health Care system, which had been working to create an ACO in Central Massachusetts announced that it would be withdrawing its proposal after finding that the financial risks were too great.