MCAAP Committees
Medicaid ACO Task Force
The initial Medicaid ACO Task Force of the Chapter focused on influencing the design of the Massachusetts 1115 Medicaid waiver so that the MassHealth program better met the needs of children, with a particular focus on primary care. Early on, the Task Force evolved to become a multidisciplinary coalition with continued strong pediatric leadership, the Massachusetts Child and Adolescent Health Initiative (CAHI). The CAHI contributed substantially to the design of the current (2022-2027) 1115 waiver that governs much of the way MassHealth operates. (https://www.healthaffairs.org/content/forefront/transforming-pediatric-primary-care-moving-theory-practice-massachusetts-and-beyond – March 2021). This waiver modified the MassHealth ACO program to include a primary care sub-capitation payment model that incentivizes advanced pediatric primary care: team care with inclusion of community health workers, greater attention and support to help with social drivers of health, and mental/behavioral health integration.
Since implementation of the current waiver, CAHI has focused on monitoring how the implementation has affected pediatric practice, examining ongoing changes in program design, and providing feedback to MassHealth to assure that children’s needs continue to be met. Its main mechanism for monitoring has been through convening two groups: 1) pediatric leaders from most of the Commonwealth’s Accountable Care Organizations (responsible for implementing the state program) and 2) a larger multidisciplinary group committed to improving child health and wellbeing through Medicaid. Three of the CAHI leaders summarized what they have learned in a recent online Health Affairs commentary. Addressing Child Health Needs Through Medicaid Accountable Care Payment Reform | Health Affairs. (March 2025)
CAHI continues to monitor implementation and modifications that MassHealth makes to the ACO program. This work will continue as MassHealth and providers respond to changes in federal policy under the current Administration and potentially the design of the next waiver. Click here to access the Massachusetts Child and Adolescent Health Initiative’s Report “Moving to the Vanguard on Pediatric Care: Child and Adolescent Health Initiative Recommendations for the MassHealth Section 1115 Waiver Renewal” – September 2020 Please contact Cathleen Haggerty at chaggerty@mcaap.org for more information.
