MassHealth Initiative will Transform Payment and Care Delivery: Are you Ready?

As has been announced by MassHealth in numerous webinars, bulletins and most recently member mailings, effective March 1, 2018 MassHealth will begin enrolling the majority on their non dual,  under 65 years of age eligible members into one of three types of Accountable Care Organizations, or one of two Managed Care Organizations .  As outlined in this provider bulletin, there are  12 different Accountable Care Plan Partnerships, and  three Primary Care ACO Plans.

Member should all have been noticed about which plan they have been assigned  as of November 2017, and their enrollments are all effective March 1, 2018. Members will have between March 1 and May 31 2018 to switch plans.  After June 1 they will remain in a fixed enrollment until Feb 2019.

MassHealth is hosting series of important webinars and live trainings for providers between Jan and March, see dates and sites in the same Provider Bulletin.

It is imperative that agencies serving MassHealth patients attend one of these trainings.  At these training Masshealth we will covering issues around eligibility verification and how to establish if a patient’s insurer has changed, as well as what plans are required to do to ensure continuity of care for patients who may be switching plans.  Most of training information will also be posted to the Delivery Reform Provider resource website.

All patients who are switching to an ACO or an MCO should have received written notice already.  These patients are being directed to www.masshealthchoices.com if they need to verify plan information or want to switch their plans.

The large number of patients facing a change in the management of their care promises to cause confusion especially for home health patients for whom continuity of service is particularly critical.  HCA of MA asks members to keep HCA informed about the transition  process.

Author: Pat Kelleher

Pat Kelleher is Executive Director of the Home Care Alliance of Massachusetts.

One thought on “MassHealth Initiative will Transform Payment and Care Delivery: Are you Ready?”

  1. Dear Pat,
    Thank you for sending this information. Byram is one of the primary medical supply companies to service MassHealth members not only for home health agencies but also other post-acute providers in the state. March is going to be a very busy month as members transition. Byram is coordinating internally at all levels to ensure not only the front line of customer service is prepared, but that our billing and verification teams are ready to minimize any disruption in service.
    Anything we can do to assist please let me know. We are committed to these MassHealth members, the new ACO’s and the agencies we service during such a significant moment of change.
    The information you sent is valuable to share with our internal teams as well.
    Thank you!
    Stacie Craig

Leave a Reply

Fill in your details below or click an icon to log in:

WordPress.com Logo

You are commenting using your WordPress.com account. Log Out /  Change )

Google photo

You are commenting using your Google account. Log Out /  Change )

Twitter picture

You are commenting using your Twitter account. Log Out /  Change )

Facebook photo

You are commenting using your Facebook account. Log Out /  Change )

Connecting to %s