Overhaul Planned for MassHealth Insurance Model

The Governor of Massachusetts, Charlie Baker, has introduced plans for the biggest overhaul of the state’s Medicaid program in two decades, changing the way doctors and hospitals are paid in an effort to rein in soaring costs.

Known as MassHealth, the program provides health coverage to about 1.8 million low-income people and accounts for the single biggest chunk of state spending. Without significant changes, administration officials say, the costs of MassHealth will continue to grow faster than state revenues, squeezing out other important programs.

Their solution is to move MassHealth away from a system that predominantly pays for each medical service provided. Instead, the administration wants to more widely implement a model known as accountable care, in which doctors and hospitals are paid set budgets to treat patients.

ACO News is a feature of the Medicaid Accountable Care Organization Resource Center, an online collection of tools designed to help Medicaid agencies develop and launch accountable care organizations.