Reform- MassHealth Selects Community Partners for Medicaid ACOs

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[MM Curator Summary]: MA is bolting on a slew community partners to its Medicaid ACO model. Or making it more official, rather.

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After seeing promising results in the first three years of the program, the Commonwealth of Massachusetts has selected 20 community partners to work with the 17 accountable care organizations (ACOs) in the state’s Medicaid program called MassHealth.

Massachusetts recently received federal approval through its 1115 demonstration to refine the ACOs and Community Partners programs over the next five years.

Community Partners work with ACOs to support MassHealth members with significant behavioral health and complex long-term services and supports needs.

Over the last three years, the Community Partners program has shown a reduction in ER visits by 21 percent, a reduction in behavioral health admissions by 30 percent, and a reduction in risk-adjusted total cost of care by 20 percent. The Behavioral Health Community Partners program complements the Commonwealth’s Roadmap for Behavioral Health Reform, which significantly expands access to mental health and addiction treatment.

“Integrating the full healthcare needs of MassHealth members with complex health conditions remains a primary goal in the next phase of the Commonwealth’s healthcare delivery restructuring,” said Secretary for Health and Human Services Marylou Sudders, in a recent statement. “Community Partners play an essential role in delivering coordinated care for MassHealth members, including individuals with disabilities, mental illness, substance misuse disorders and co-occurring disorders.”

The goals of the Community Partners program for the next five years include:

  • Re-affirming MassHealth’s commitment to community-based outreach and care coordination for the highest-risk members, leveraging the expertise of community-based organizations;
  • Continuing to incentivize integration of care across physical health, behavioral health, long-term services and supports, and health-related social needs;
  • Strengthening Community Partners’ accountability for outcomes and standardizing expectations for the delivery of care coordination supports; and
  • Simplifying and streamlining the relationships between Community Partners and ACOs.

The announcement includes the selection of 12 Behavioral Health and eight Long-Term Services and Supports Community Partner organizations. MassHealth ACOs and managed care organizations will contract directly with Community Partner organizations, with the goal of improving integration and care coordination for MassHealth members.

The selected Long-Term Services and Supports Community Partners are:

  • Behavioral Health Network, Inc.
  • Boston Medical Center Corp.
  • Center for Human Development 
  • Community Care Partners, LLC 
  • Family Service Association of Greater Fall River, Inc 
  • Greater Lynn Senior Services 
  • Open Sky Community Services    
  • Seven Hills Family Services 

The selected Behavioral Health Community Partners are:

  • Behavioral Health Network, Inc.
  • Behavioral Health Partners of MetroWest 
  • Boston Health Care for the Homeless Program, Inc. 
  • The Brien Center 
  • Center for Human Development 
  • Clinical and Support Options, Inc. 
  • Community Care Partners, LLC 
  • Community Counseling of Bristol County 
  • Eliot Community Human Services, Inc 
  • Open Sky Community Services 
  • Riverside Community Care, Inc 
  • Stanley Street Treatment and Resources, Inc.