Massachusetts

Massachusetts Capitated Financial Alignment Model Demonstration (One Care)

 

SPOTLIGHT & RELEASES
08/14/2019 - Massachusetts Medicare-Medicaid Plan Quality Withhold Analysis Results for Demonstration Year 4 (PDF)
08/05/2019 - Three-Way Contract Extension (08/01/2019) (PDF) & Summary of Contract Extension Changes (08/01/2019) (PDF)

Key Dates

August 22, 2012 - CMS and Massachusetts sign MOU

July 16, 2013 - CMS, Massachusetts, and participating plans execute three-way contract

October 1, 2013 - Start of opt-in enrollment

January 1, 2014 - Start of passive enrollment

December 31, 2015 - CMS, Massachusetts, and participating plans execute updated three-way contract

July 5, 2016 - CMS, Massachusetts, and participating plans execute updated three-way contract

June 11, 2018 - CMS, Massachusetts, and participating plans execute updated three-way contract

March 1, 2019 - CMS, Massachusetts, and participating plans execute updated three-way contract

August 1, 2019 - CMS, Massachusetts, and participating plans execute three-way contract extension

One Care Model

On August 23, 2012, the Centers for Medicare & Medicaid Services (CMS) announced that the Commonwealth of Massachusetts will partner with CMS in the Financial Alignment Initiative to test a new model for providing Medicare-Medicaid enrollees with a more coordinated, person-centered care experience.

Under the demonstration, also called "One Care: MassHealth plus Medicare," CMS and Massachusetts will contract with "One Care" plans that will coordinate the delivery of and be accountable for all covered Medicare, Medicaid, and expanded services for participating Medicare-Medicaid enrollees in the Commonwealth. 

More information from CMS:

Information for Plans:

Information for Beneficiaries and Providers:

Information from the Commonwealth of Massachusetts:

Funding Support:

Massachusetts "Duals Demonstration 2.0" Proposal for Public Comment:

The Massachusetts Executive Office of Health and Human Services has submitted for CMS review a proposal for a new demonstration that would include both the One Care demonstration (for dually eligible individuals under age 65) and the Senior Care Options Dual Eligible Specials Needs Plan program (for dually eligible individuals ages 65 and older).

CMS welcomed public input on this proposal, which is available on the Integrated Care Resource Center website, through October 17, 2018.

Page Last Modified:
10/01/2019 11:59 PM