Massachusetts Receives One Care Capitated Model Demonstration Annual Evaluation.

Massachusetts has received the first annual evaluation report of the One Care Capitated Model Demonstration under the Medicare-Medicaid Financial Alignment. According to a recent CMS communication, “CMS and the Commonwealth of Massachusetts have partnered with health plans to provide comprehensive, coordinated care for eligible individuals. The One Care demonstration leverages these enrollees under age 65 at the time of enrollment.  The results in this report are based on experience during the first demonstration performance period, from October 2013 – December 2014.”

 Highlights from the report include:

  •  State officials and stakeholders indicated strong support for One Care and its integrated approach to service delivery for the population of Medicare-Medicaid beneficiaries it serves.
  • Using the LTS coordinator was considered to be a key component of the One Care demonstration, and MassHealth, the plans, and stakeholders widely supported it. Although challenging to implement, the LTS coordinator role was seen as particularly important to introducing independent living skills and recovery model services to One Care enrollees.
  • Enrollment in the demonstration has been low, with about 18 percent of eligible Medicare-Medicaid beneficiaries enrolled in One Care as of July 1, 2015.
  • From the perspective of MassHealth officials, passive enrollment was a necessary and important component of the demonstration and provided the vehicle for bringing the model to scale and achieving the greatest impact on the most people.
  • Especially important to beneficiaries have been enhanced benefits, such as care coordination, LTSS, and dental services, not all of which were available to all enrollees before the demonstration.

 The RTI evaluation team will continue to collect information on a quarterly basis from Massachusetts officials through the online State Data Reporting System, covering enrollment statistics and updates on key aspects of implementation.