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Protocol establishing the structure, funding mechanisms, accountability framework, participation requirements, and reporting processes for the Delivery System Reform Incentive Payment program within the MassHealth Medicaid Section 1115 Demonstration.
Jurisdiction:
Massachusetts, United States
Program:
MassHealth Medicaid Section 1115 Demonstration
Document Type:
Program protocol
Subject:
Health care delivery system reform and incentive payment framework
Administering Agency:
MassHealth
Related Authority:
Centers for Medicare & Medicaid Services (CMS)
Program Components:
Accountable Care Organizations (ACOs), Community Partners (CPs), Community Service Agencies (CSAs)
Funding Mechanism:
Delivery System Reform Incentive Payment (DSRIP)
Approval Period:
July 1, 2017 – December 31, 2027
Key Topics:
Participation plans, budgets, payment methodologies, accountability framework, statewide investments, reporting and oversight
Stakeholders:
ACOs, Community Partners, Community Service Agencies, State government, CMS
Evaluation and Oversight:
CMS oversight and state evaluation requirements
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Year:
2018
Region / City:
Northern Region
Topic:
Behavioral Health, Health Services
Document Type:
Executive Summary
Organization / Institution:
Lahey Health Behavioral Services (LHBS)
Author:
Not specified
Target Audience:
Mass Health members, healthcare providers, community partners
Period of Activity:
June 1, 2018 to December 31, 2018
Date of Approval:
Not specified
Date of Changes:
Not specified
Description of Goal 1:
Relationships
Description of Goal 2:
Workforce
Description of Goal 3:
Tools and Documented Process
Description of Goal 4:
Value Proposition
Year:
2014
Region:
Texas, USA
Program:
Medicaid and CHIP
Document Type:
Technical Notes / Report
Organization:
Institute for Child Health Policy, University of Florida
External Reviewer:
External Quality Review Organization for Texas Medicaid Managed Care and CHIP
Author:
Not specified
Target Audience:
Healthcare providers, hospital administrators, policymakers
Issue Date:
March 21, 2016
Content:
Methodology, data inclusion criteria, POA quality checks, PPC calculations, hospital and state-level PPC results
Measurement Year:
Calendar Year 2014
PPC Categories:
65
POA Quality Check Levels:
Red zone, Grey zone
Excluded Populations:
Dual-eligible Medicaid/Medicare, low-volume hospitals, severe or catastrophic illness patients
Year:
2017
Region / City:
Massachusetts
Topic:
Healthcare, Medicaid
Document Type:
Official Communication
Organization / Institution:
Centers for Medicare & Medicaid Services
Author:
Angela D. Garner
Target Audience:
State Officials, Healthcare Administrators
Period of Validity:
N/A
Approval Date:
May 15, 2017
Date of Changes:
N/A
Year:
PY2
Region / City:
New Bedford, MA
Topic:
Behavioral Health, Community Health Program
Document Type:
Annual Report
Organization / Institution:
Coordinated Care Network
Affiliated Partners:
High Point Treatment Center, Child & Family Services, Duffy Health Center, Steppingstone, Brockton Area Multi Services, Inc., Bay State Community Services
Subcontractors:
Community Health Center of Cape Cod, Brockton Neighborhood Health Center
Program:
DSRIP
Activities:
Outreach, engagement incentives, community education, care coordination, technology improvements, staff training and retention, quality assurance
Target Audience:
Program stakeholders, funders
Period Covered:
Budget Period 2
Date Submitted:
Not specified
Year:
2021
Region:
Massachusetts, USA
Theme:
Behavioral Health Workforce Development
Document Type:
Request for Proposals
Issuing Organization:
Commonwealth Corporation
Funding Organizations:
MassHealth Delivery System Reform Incentive Payment (DSRIP), RIZE Massachusetts Foundation, Inc.
Target Audience:
Community behavioral health organizations, healthcare workforce programs
Application Deadline:
October 27, 2021, 5:00 PM EST
Submission Method:
Electronic submission via https://commcorp.tfaforms.net/328900
Contacts:
Karen Shack ([email protected]), Anthony Britt ([email protected])
Website:
www.commcorp.org
Program Goals:
Expand behavioral health workforce, improve recruitment and retention, address workforce shortages, support treatment for SUD and OUD
Grant Components:
Training and Placement Programs, Training and Advancement Programs, Clinical Supervision and Mentorship, Capacity Building
Evaluation Criteria:
Proposal review on rolling basis
Year:
2025
Region / City:
Massachusetts
Subject:
Medicaid, Health Insurance
Document Type:
Amendment Request
Agency / Institution:
Executive Office of Health and Human Services
Author:
Not specified
Target Audience:
Stakeholders in healthcare policy and Medicaid administration
Effective Period:
2025-2027
Approval Date:
January 21, 2025
Amendment Date:
Pending
Year:
2024
Region / City:
Massachusetts
Topic:
Public expenditure process, temporary housing assistance
Document Type:
Policy Document
Agency / Institution:
Executive Office of Housing and Livable Communities (EOHLC)
Author:
Commonwealth of Massachusetts
Target Audience:
Government entities, healthcare providers, social service agencies
Period of Effect:
From September 30, 2024, onwards
Approval Date:
September 30, 2024
Amendment Date:
Not specified
Year:
2022-2027
Region / City:
Massachusetts
Topic:
Independent Evaluation Design
Document Type:
Evaluation Design Document
Organization / Institution:
UMass Chan Medical School, Massachusetts Executive Office of Health and Human Services, Centers for Medicare and Medicaid Services
Author:
UMass Chan Medical School
Target Audience:
Centers for Medicare and Medicaid Services, healthcare policymakers, health service providers
Approval Date:
December 2023
Amendment Date:
Not provided
Period of Validity:
2022-2027
Year:
2022-2027
Region / city:
Massachusetts
Topic:
Medicaid Demonstration
Document type:
Program Report
Agency / institution:
MassHealth
Author:
MassHealth
Target audience:
Stakeholders, Policy Makers, Health Providers
Effective period:
October 1, 2022 - December 31, 2027
Approval date:
October 1, 2022
Date of changes:
N/A
State:
Oklahoma
Demonstration name:
Institutions for Mental Diseases Waiver for Serious Mental Illness/Substance Use Disorder
Approval period for section 1115 demonstration:
12/22/2020-12/31/2025
SMI/SED demonstration start date:
12/22/2020
Implementation date of SMI/SED demonstration:
12/22/2020
SMI/SED demonstration goals and objectives:
Reduced utilization of emergency departments; Reduced preventable readmissions to acute care hospitals and residential settings; Improved availability of crisis stabilization services; Improved access to community-based services; Improved care coordination
SMI/SED demonstration year and quarter:
DY1 Q2
Reporting period:
04/01/2021 - 06/30/2021
Medicaid expansion start date:
07/01/2021
Managed care implementation status:
On hold pending legislative authority
Behavioral Health Homes sunset date:
09/30/2021
Certified Community Behavioral Health Clinics (CCBHCs) certified this period:
1
Total new CMHCs achieving CCBHC status since waiver submission:
4
State agency:
Oklahoma Department of Mental Health and Substance Abuse Services (ODMHSAS)
Relevant national initiatives:
988 crisis response number
Year:
2022
Region / City:
Massachusetts
Theme:
Medicaid, Health Services, Demonstration Programs
Document Type:
Report
Agency / Institution:
Centers for Medicare & Medicaid Services, UMass Chan Medical School
Author:
Danielle Daly, Jay Himmelstein, Matthew Alcusky, Arlene Ash, et al.
Target Audience:
Health Policy Makers, Researchers, Health Administrators
Evaluation Period:
June 2017 - December 2019
Approval Date:
September 29, 2022
Amendment Date:
March 18, 2022
Year:
2022
Region / City:
Massachusetts
Theme:
Healthcare, Medicaid
Document Type:
Quarterly Report
Organization / Institution:
Massachusetts Executive Office of Health and Human Services (EOHHS)
Author:
Not specified
Target Audience:
Policy makers, healthcare administrators, healthcare providers
Period of Action:
July 1, 2022 – September 30, 2022
Approval Date:
Not specified
Date of Changes:
June 9, 2022 (Temporary Extension)
Año:
2021
Región / ciudad:
Estados Unidos
Temática:
Derecho de marcas
Tipo de documento:
Instrucción judicial
Organismo / institución:
Oficina de Patentes y Marcas de EE.UU.
Autor:
Tribunal judicial
Público objetivo:
Abogados, jueces, partes involucradas en casos de infracción de marcas
Periodo de validez:
No especificado
Fecha de aprobación:
No especificado
Fecha de modificaciones:
No especificado
Note:
Descripción
Year:
2024
Region / City:
Massachusetts
Theme:
Medicaid, Healthcare, Integrated Care
Document Type:
Amendment Request
Organization:
Executive Office of Health and Human Services (EOHHS)
Author:
EOHHS
Target Audience:
Medicaid and Medicare beneficiaries, healthcare providers, policymakers
Effective Period:
2026
Approval Date:
Not specified
Date of Modifications:
Not specified
Year:
2015
Month:
October
ISBN:
978-0-478-43513-9
Document Code:
DGL 11/15
Country:
New Zealand
Issuing Authority:
Director of the Ministry of Civil Defence & Emergency Management
Publishing Organisation:
Ministry of Civil Defence & Emergency Management
Legal Basis:
Civil Defence Emergency Management (CDEM) Act 2002, section 9(3)
Type of Document:
Director’s Guideline
Subject:
Welfare services and needs assessment in emergencies
Scope:
National and CDEM Group levels
Responsible Agencies:
MCDEM and CDEM Groups including local authorities
Target Audience:
CDEM Groups and agencies with responsibilities for welfare services in an emergency
Related Framework:
National Civil Defence Emergency Management Plan 2015
Contact Address:
PO Box 5010 Wellington 6145 New Zealand
Website:
www.civildefence.govt.nz
Copyright Status:
Not copyright; reproduction permitted with acknowledgement
Number:
11-W-00030/1
Program Title:
MassHealth Medicaid Section 1115 Demonstration
Awardee:
Massachusetts Executive Office of Health and Human Services (EOHHS)
Federal Agency:
Centers for Medicare & Medicaid Services (CMS)
State:
Massachusetts
Effective Date:
July 1, 2017
Expiration Date:
June 30, 2022
Demonstration Authority:
Section 1115(a) of the Social Security Act
Extension Approval Date:
November 4, 2016
Demonstration Period:
State Fiscal Years 2018–2022
Subject Areas:
Program Description and Objectives; General Program Requirements; Eligibility and Enrollment; Demonstration Programs and Benefits; Delivery System; Cost Sharing; Safety Net Care Pool; Reporting; Monitoring; Evaluation; Financial Requirements; Budget Neutrality; Schedule of Deliverables
Key Components:
Accountable Care Organization (ACO) initiative; Delivery System Reform Incentive Program (DSRIP); Safety Net Care Pool (SNCP)
Target Populations:
Medicaid beneficiaries; low-income uninsured individuals; former foster care individuals aged 18–26
Legal Compliance Requirements:
Federal non-discrimination statutes; Medicaid and CHIP law and regulation
Financial Framework:
Federal Financial Participation (FFP); budget neutrality agreement; allotment neutrality worksheet
Attachments:
A–S including Cost Sharing, SNCP Payments, DSRIP Protocol, ACO Payment Methodology, Evaluation Design
State:
Ohio
Demonstration Name:
Ohio Section 1115 Substance Use Disorder Waiver Demonstration
Approval Period:
10/01/2019 – 09/30/2024
SUD Demonstration Start Date:
10/01/2019
Implementation Date:
n.a.
Demonstration Year and Quarter:
DY2Q3
Reporting Period:
04/01/2021 – 06/30/2021
Demonstration Goals:
Increase identification, initiation, and engagement in treatment; improve retention and adherence; reduce overdose deaths; reduce inappropriate ED and inpatient utilization; reduce readmissions; improve access to physical health care for SUD beneficiaries
Metrics Reported:
ASAM level service utilization, MAT utilization, UDS utilization
Target Populations:
Youth, Dual, Criminal Justice Involved, Pregnant, Older Adults
Milestones:
Assessment of need and qualification for SUD services, Access to critical levels of care for OUD and other SUDs
Context:
Official state report providing quarterly metrics, milestone updates, and implementation details for the Ohio Section 1115 SUD Waiver Demonstration
Year:
2021
Region:
Massachusetts, United States
Subject:
Medicaid policy, postpartum coverage, maternal health, telehealth services
Document Type:
Public comments and testimony
Government Program:
MassHealth Section 1115 Demonstration Waiver
Submitting Organizations:
Massachusetts Chapter of the American Academy of Pediatrics; Massachusetts Section of the American College of Obstetricians and Gynecologists; Massachusetts Medical Society; Children’s Health Access Coalition; Boston Medical Center Health System; Commonwealth Care Alliance; Planned Parenthood League of Massachusetts; Massachusetts Health & Hospital Association; Massachusetts Law Reform Institute; Association for Behavioral Healthcare; Health Care For All; Massachusetts Academy of Family Physicians; Mass General Brigham
Individual Contributor:
Isabella Hernandez
Government Body Referenced:
Executive Office of Health and Human Services
Federal Agency Referenced:
Centers for Medicare and Medicaid Services
Public Comment Period:
March 23, 2021 to April 25, 2021
Key Policy Proposals:
Extension of postpartum coverage to 12 months; authorization of coverage regardless of immigration status; expansion of Medicare Savings Programs eligibility; community support services for justice-involved individuals; telehealth payment flexibility
Date of Testimony:
April 20, 2021
Year:
2017
Region / City:
Massachusetts
Topic:
Healthcare, Medicaid
Document Type:
Official Communication
Organization / Institution:
Centers for Medicare & Medicaid Services
Author:
Angela D. Garner
Target Audience:
State Officials, Healthcare Administrators
Period of Validity:
N/A
Approval Date:
May 15, 2017
Date of Changes:
N/A
Year:
2022
Region / City:
Massachusetts
Theme:
Medicaid, CHIP, Healthcare Waivers
Document Type:
Demonstration Waiver Approval
Institution:
Massachusetts Executive Office of Health and Human Services (EOHHS)
Author:
Centers for Medicare & Medicaid Services
Target Audience:
Government officials, healthcare providers, policy makers
Period of Validity:
October 1, 2022 – December 31, 2027
Date of Approval:
October 1, 2022
Date of Changes:
N/A