Uncovering Opportunities to Improve the MassHealth Accountable Care Organization Program

MassHealth’s Accountable Care Organization (ACO) program launched in 2018 with the goal of transforming the way health care is delivered to MassHealth members. As with any major reform, there have been successes and challenges. This qualitative analysis of the ACO program found that stakeholders believe it is helping to provide better care to MassHealth members and are committed to its success. The report also identifies opportunities for the ACO program to be improved, noting that its complexity has compromised the speed and efficiency of implementation.

This analysis was informed by a series of interviews with 34 individuals from 21 organizations. In close partnership with the Center for Health Care Strategies (CHCS) and Blue Cross Blue Shield of Massachusetts Foundation, JSI contributed to an environmental scan, participated in key informant interviews, and prepared vignettes (brief case studies) that were included in the full report. The vignettes highlighted program innovations, exemplifying the overall successes and challenges with MassHealth’s transition to ACOs. JSI identified potential vignettes through discussions during key informant interviews. We drafted the organizational vignettes, which involved conducting more in-depth interviews with the relevant ACOs, community partners (CPs), and social service organizations (SSOs) to gather specific information about program innovations and improvements in MassHealth members experiences and health outcomes. The report also makes specific programmatic recommendations for strengthening the ACO program moving forward. These recommendations focus on:

• Improving communication and data sharing among ACOs, CPs, and SSOs
• Dismantling structural elements of the program that hinder partnerships in the CP and Flexible Services Programs.

Read more about the key themes that emerged from the research or connect directly with our project team to learn about this work.